Invasive Paranasal and Pulmonary Aspergillosis in a Post-COVID Patient with Diabetes

Abstract

COVID-positive patients and those recovering from COVID affliction are more susceptible to fungal infections. It is especially
true in patients who are diabetic, on prolonged glucocorticoid medications and transplant patients. In critically ill patients,
invasive fungal infections have a bad prognosis resulting in grim figures of morbidity. Glucocorticoid medications may aggravate
hyperglycemia in patients with diabetes which present a favorable ground for fungal infections. In this case, we have come
across a patient who has a long-standing history of diabetes. She has been suffering from invasive pulmonary aspergillosis
while recovering from COVID-19. The diagnosis of invasive aspergillosis is difficult using clinical criteria, thus imaging modalities
are the mainstay for diagnosis. Intravenous voriconazole (400 mg BD tapered down to 200 mg) has been used to treat her
condition. Patients who are on glucocorticoids, have deteriorating pulmonary functions, and are diabetic have increased risk
of developing aspergillosis.