Fatal invasive candidiasis in COVID-19 patient with severe bleeding and extensively drug-resistant Klebsiella enterobacter

• Published in: Journal of infection in developing countries Vol. 16; no. 6; pp. 1025 - 1029
• Main Authors: Adzic-Vukicevic, Tatjana, Velickovic, Jelena, Radovanovic-Spurnic, Aleksandra, Velickovic, Dejan, Milenkovic, Sara, Petrovic, Filip, Micic, Jelena, Dragutinovic, Natasa
• Format: Journal Article
• Language: English
• Published: Sassari Journal of Infection in Developing Countries 30.06.2022
• Subjects: Bacterial infections; Coronaviruses; COVID-19; Drug resistance; Fungal infections; Hemorrhage; Mortality; Serbia; China
• ISSN: 1972-2680; 2036-6590; 1972-2680
• DOI: 10.3855/jidc.16256

Introduction: Multi-organ dysfunction caused by thromboembolic complications may complicate the course of SARS-CoV-2 infection. Most patients require anticoagulant therapy which predisposes them to the development of hemorrhagic syndrome. In critically ill COVID-19 patients secondary infections due to opportunistic pathogens are associated with a high mortality rate. Case report: Herein, we present a COVID-19 patient with severe hemorrhage at unusual sites complicated with invasive candidiasis and an extensively drug-resistant (XDR) strain of Klebsiella enterobacter. Conclusions: Clinicians should be aware of the possibility for invasive fungal infections in severely ill patients with SARS-CoV-2 infection due to pre-existing conditions, risk factors, and COVID-19 associated pathological mechanisms. Management of invasive candidiasis is challenging because of the high prevalence of comorbidities, risk of toxicities, and drug interactions.