Sobreinfección por Pneumocystis jirovecii y Staphylococcus aureus resistente a meticilina tras infección por SARS-CoV2.

• Main Authors: Marta Olimpia Lago Rodríguez (Author), Crhistian Mario Amodeo Oblitas (Author), Carmen Cuenca Carvajal (Author)
• Format: Book
• Published: Sociedade Galega de Medicina Interna, 2022-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0304-4866; 1989-3922; 10.22546/67/2847
• Keywords: corticosteroides; sarm; neumonía organizada; pneumocystis jirovecii; sars-cov2; Medicine; R; Internal medicine; RC31-1245
• Source: Galicia Clínica, Vol 83, Iss 4, Pp 44-46 (2022)

We present a case of an 87-year-old nonsmoker female who recovered after infection by SARS-CoV2 and was readmitted two weeks later due to respiratory sepsis. Radiological imaging showed a significant radiological worsening with extensive areas of bronchopneumonia and ground-glass opacities suggestive of organizing pneumonia. Empirical treatment with meropenem 1g/8h was started; however, clinical worsening persisted with tachypnea and desaturation requiring heated high-flow nasal cannula oxygen therapy, with poor response. Methicillin-resistant Staphylococcus aureus was isolated both in nare screening and sputum, and 16S rRNA polymerase chain reaction in induced sputum was positive for P. jirovecii. Serum (1-3)-beta-D-glucan was normal, and blood cultures were sterile. Antibiotic therapy was adjusted with intravenous linezolid 600mg/12h and trimethoprim-sulfamethoxazole 1600/320mg/6h, plus methylprednisolone 40mg/day. Unfortunately, the patient had no response to optimized treatment and finally died. Opportunistic and resistant microorganisms superinfections should be aware by clinicians in SARS-CoV2 infection, even more, when corticosteroids are widely used.