Abstract
Rationale: Bacterial and fungal infections in Coronavirus Disease-19 (COVID-19) patients have been inadequately investigated and reported thus far. The safety profile of tocilizumab (TCZ) administration in candidemia patient still debatable.
Patient concerns: A 54 year-old woman presenting with weakness on the left side of her body was diagnosed with COVID-19. After 7 days of admission, her condition worsened and developed respiratory distress and was having respiratory distress despite standard treatment.
Diagnoses: Acute respiratory distress syndrome (ARDS) in COVID 19 was diagnoses based on real time-PCR swab, deterioration of PaO2/FiO2 and increased of acute phase reactants.
Interventions: Anti Interleukin-6 (IL-6) was considered to tackle her inflammatory condition. Prior to TCZ administration, blood culture was performed and the result came with Candida tropicalis in the absence of bacterial growth.
Outcomes: No major complications associated with intravenous antifungal or TCZ occurred. After 40 days of hospitalization, the patient’s clinical condition improved and was finally discharged.
Lessons: This case underscores the safety profile of giving TCZ in candidemia as a secondary infection in severe COVID-19 patient.
【초록키워드】 COVID-19, ARDS, severe COVID-19, Hospitalization, Tocilizumab, IL-6, Infection, COVID 19, Deterioration, Culture, Patient, Complication, Swab, real time-PCR, Admission, safety profile, Blood, diagnose, Bacterial, acute phase reactants, administration, distress, Fungal infection, intravenous, Candida tropicalis, paO2/fiO2, standard treatment, growth, syndrome, weakness, clinical condition, inflammatory condition, occurred, reported, the patient, investigated, was performed, absence, discharged, presenting, debatable, diagnosed with COVID-19, TCZ, worsened, 【제목키워드】 severe COVID-19, Tocilizumab, Fungal infection, role,