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Case Report
Pulmonary
A fatal case report of invasive pulmonary aspergillosis and mucormycosis coinfection in an immunocompetent patient with coronavirus disease 2019 in Korea
Jin Hyoung Kim, Misung Kim, Soyeoun Lim, Sun Young Park, Yangjin Jegal, Taehoon Lee, Byung Ju Kang
Acute Crit Care. 2023;38(3):382-388.   Published online June 27, 2022
DOI: https://doi.org/10.4266/acc.2021.01340
  • 3,637 View
  • 116 Download
  • 5 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Systemic glucocorticoid treatment is highly recommended in critically ill coronavirus disease 2019 (COVID-19) patients. However, secondary fungal infections are of concern in such patients. Here, we describe the first case of COVID-19-associated invasive pulmonary aspergillosis (CAPA) and COVID-19-associated mucormycosis (CAM) coinfection in a COVID-19 positive immunocompetent patient in Korea. A 69-year-old man was admitted to our hospital with COVID-19 pneumonia. He had no underlying comorbidities and was not taking medications. He received remdesivir, dexamethasone, and antibiotic therapy under mechanical ventilation. Although his condition improved temporarily, multiple cavities were observed on chest computed tomography, and Aspergillus fumigatus was cultured from tracheal aspiration culture. He was diagnosed with probable CAPA and received voriconazole therapy. However, his condition was not significantly improved despite having received voriconazole therapy for 4 weeks. After release from COVID-19 quarantine, he underwent bronchoscopy examination and was then finally diagnosed with CAPA and CAM coinfection on bronchoscopic biopsy. Antifungal treatment was changed to liposomal amphotericin B. However, his progress deteriorated, and he died 4 months after admission. This case highlights that clinical suspicion and active checkups are required to diagnose secondary fungal infections in immunocompetent COVID-19 patients who receive concurrent glucocorticoid therapy.

Citations

Citations to this article as recorded by  
  • Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
    Sin Young Ham, Seungjae Lee, Min-Kyung Kim, Jaehyun Jeon, Eunyoung Lee, Subin Kim, Jae-Phil Choi, Hee-Chang Jang, Sang-Won Park
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Mixed Aspergillosis and Mucormycosis Infections in Patients with COVID-19: Case Series and Literature Review
    Elahe Sasani, Farzad Pakdel, Sadegh Khodavaisy, Mohammadreza Salehi, Amir Salami, Marjan Sohrabi, Pouyan Aminishakiba, Iman Amirafzali, Arezoo Salami Khaneshan
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  • Prevalence of co‐existent COVID‐19‐associated pulmonary aspergillosis (CAPA) and its impact on early mortality in patients with COVID‐19‐associated pulmonary mucormycosis (CAPM)
    Valliappan Muthu, Ritesh Agarwal, Shivaprakash Mandya Rudramurthy, Deepak Thangaraju, Manoj Radhakishan Shevkani, Atul K. Patel, Prakash Srinivas Shastri, Ashwini Tayade, Sudhir Bhandari, Vishwanath Gella, Jayanthi Savio, Surabhi Madan, Vinaykumar Hallur,
    Mycoses.2024;[Epub]     CrossRef
  • Aspergillosis coinfection in patients with proven mucormycosis
    Sang Hyun Ra, Ji Yeun Kim, Joon Seon Song, Hyeon Mu Jang, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Sung-Han Kim
    Medical Mycology.2024;[Epub]     CrossRef
  • Successful treatment of mixed pulmonary Aspergillus and Mucor infection using intrabronchial amphotericin B infusion: a case report and literature review
    Fei-Xiang Ling, Dong-Ming Qu, Ye-Quan Lu, Rou Li, Lei Zhao
    BMC Pulmonary Medicine.2024;[Epub]     CrossRef
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    Sang Hwan Lee, Yun Jin Kim, Jaehoon Oh, Hyunggoo Kang, Kyung Hun Yoo, Byuk Sung Ko, Tae Ho Lim, Bo-Guen Kim, Hyun Lee, Sang-Heon Kim, Jang Won Sohn, Ho Joo Yoon, Hayoung Choi, Yongil Cho, Dong Won Park
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Dual Disseminated Aspergillosis and Mucormycosis Diagnosed at Autopsy: A Report of Two Cases of Coinfection and a Review of the Literature
    Jason Murray, Zhen A. Lu, Karin Miller, Alex Meadows, Marissa Totten, Sean X. Zhang
    Journal of Fungi.2023; 9(3): 357.     CrossRef
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    Sara Mina, Hajar Yaakoub, Cédric Annweiler, Vincent Dubée, Nicolas Papon
    Microbes and Infection.2022; 24(8): 105039.     CrossRef
Original Articles
Epidemiology
Characteristics, management and clinical outcomes of patients with sepsis: a multicenter cohort study in Korea
Kyeongman Jeon, Soo Jin Na, Dong Kyu Oh, Sunghoon Park, Eun Young Choi, Seok Chan Kim, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Sang Hyun Kwak, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Jae Hwa Cho, Beongki Kim, Chae‐Man Lim
Acute Crit Care. 2019;34(3):179-191.   Published online July 1, 2019
DOI: https://doi.org/10.4266/acc.2019.00514
  • 9,502 View
  • 337 Download
  • 24 Web of Science
  • 28 Crossref
AbstractAbstract PDF
Background
Mortality rates associated with sepsis have increased progressively in Korea, but domestic epidemiologic data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of sepsis patients in Korea.
Methods
This study is a multicenter retrospective cohort study. A total of 64,021 adult patients who visited an emergency department (ED) within one of the 19 participating hospitals during a 1-month period were screened for eligibility. Among these, patients diagnosed with sepsis based on the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were included in the study.
Results
Using the Sepsis-3 criteria, 977 sepsis patients were identified, among which 36.5% presented with septic shock. The respiratory system (61.8%) was the most common site of infection. The pathogen involved was identified in 444 patients (45.5%) and multi-drug resistance (MDR) pathogens were isolated in 171 patients. Empiric antibiotic therapy was appropriate in 68.6% of patients, but the appropriateness was significantly reduced in infections associated with MDR pathogens as compared with non-MDR pathogens (58.8% vs. 76.0%, P<0.001). Hospital mortality was 43.2% and 18.5% in sepsis patients with and without shock, respectively. Of the 703 patients who survived to discharge, 61.5% were discharged to home and 38.6% were transferred to other hospitals or facilities.
Conclusions
This study found the prevalence of sepsis in adult patients visiting an ED in Korea was 1.5% (15.2/1,000 patients). Patients with sepsis, especially septic shock, had a high mortality and were often referred to step-down centers after acute and critical care.

Citations

Citations to this article as recorded by  
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    Journal of Korean Medical Science.2024;[Epub]     CrossRef
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    Charlotte Berninghausen, Frank Schwab, Alexander Gropmann, Bernd A. Leidel, Rajan Somasundaram, Lydia Hottenbacher, Petra Gastmeier, Sonja Hansen
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    Joong-Yub Kim, Hong Yeul Lee, Jinwoo Lee, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, Sang-Min Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
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    Namkee Oh, Won Chul Cha, Jun Hyuk Seo, Seong-Gyu Choi, Jong Man Kim, Chi Ryang Chung, Gee Young Suh, Su Yeon Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Ryoung-Eun Ko
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    Jiwon Lee, Hee-Ju Kim
    Clinical Nursing Research.2024; 33(8): 610.     CrossRef
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    Youjin Chang, Ju Hyun Oh, Dong Kyu Oh, Su Yeon Lee, Dong-gon Hyun, Mi Hyeon Park, Chae-Man Lim, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Su Yeon Lee, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park,
    Critical Care.2024;[Epub]     CrossRef
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    Priyo Sasmito, Satriya Pranata, Rian Adi Pamungkas, Etika Emaliyawati, Nisa Arifani
    Acute and Critical Care.2024; 39(4): 545.     CrossRef
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    Chul Park, Nam Su Ku, Dae Won Park, Joo Hyun Park, Tae Sun Ha, Do Wan Kim, So Young Park, Youjin Chang, Kwang Wook Jo, Moon Seong Baek, Yijun Seo, Tae Gun Shin, Gina Yu, Jongmin Lee, Yong Jun Choi, Ji Young Jang, Yun Tae Jung, Inseok Jeong, Hwa Jin Cho, A
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    Rehab Salah Taha, Mohamed Elsayed Afandy, Abdelaziz Hamid Elbadawi, Mohamed Samir Abd El Ghafar
    Egyptian Journal of Anaesthesia.2023; 39(1): 56.     CrossRef
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    Hyung-Jun Kim, Dong Kyu Oh, Sung Yoon Lim, Young-Jae Cho, Sunghoon Park, Gee Young Suh, Chae-Man Lim, Yeon Joo Lee
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    Se Hun Kim, Ki Hoon Kim
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  • Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia
    Tae Wan Kim, Se-Uk Lee, Boram Park, Kyeongman Jeon, Sunghoon Park, Gee Young Suh, Dong Kyu Oh, Soo Yeon Lee, Mi Hyeon Park, Haein Lee, Chae-man Lim, Ryoung-Eun Ko, Sang-Bum Hong, Suk-Kyung Hong, Yeon Joo Lee, Young-Jae Cho, Sung Yoon Lim, Jeongwon Heo, Ja
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Rapid response system
Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey
Yeonhee Park, Jong-Joon Ahn, Byung Ju Kang, Young Seok Lee, Sang-Ook Ha, Jin-Soo Min, Woo-Hyun Cho, Se-Hee Na, Dong-Hyun Lee, Seung-Yong Park, Goo-Hyeon Hong, Hyun-Jung Kim, Sangwoo Shim, Jung-Hyun Kim, Seok-Jeong Lee, So-Young Park, Jae Young Moon
Korean J Crit Care Med. 2017;32(3):231-239.   Published online August 31, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00024
  • 8,594 View
  • 236 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary Material
Background
Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals. Methods: This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present. Results: Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001). Conclusions: RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.

Citations

Citations to this article as recorded by  
  • Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023
    Kimia Honarmand, Randy S. Wax, Daleen Penoyer, Geoffery Lighthall, Valerie Danesh, Bram Rochwerg, Michael L. Cheatham, Daniel P. Davis, Michael DeVita, James Downar, Dana Edelson, Alison Fox-Robichaud, Shigeki Fujitani, Raeann M. Fuller, Helen Haskell, Ma
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    Jaehoon Oh, Kyoung-Chul Cha, Jong-Hwan Lee, Seungmin Park, Dong-Hyeok Kim, Byung Kook Lee, Jung Soo Park, Woo Jin Jung, Dong Keon Lee, Young Il Roh, Tae Youn Kim, Sung Phil Chung, Young-Min Kim, June Dong Park, Han-Suk Kim, Mi Jin Lee, Sang-Hoon Na, Gyu C
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    Jin Hyoung Kim, Jihye Kim, SooHyun Bae, Taehoon Lee, Jong-Joon Ahn, Byung Ju Kang
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Case Report
Neurology/Obstetric
A Critical Case of Wernicke's Encephalopathy Induced by Hyperemesis Gravidarum
Byung Ju Kang, Min Gu Kim, Jwa Hoon Kim, Mingee Lee, Sang-Beom Jeon, Ha Il Kim, Jin Won Huh
Korean J Crit Care Med. 2015;30(2):128-131.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.128
  • 7,148 View
  • 101 Download
  • 3 Crossref
AbstractAbstract PDF
Wernicke’s encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke’s encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke’s encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.

Citations

Citations to this article as recorded by  
  • Wernicke's Encephalopathy in Acute and Chronic Kidney Disease: A Systematic Review
    Erik Oudman, Jan W. Wijnia, David Severs, Misha J. Oey, Mirjam van Dam, Maaike van Dorp, Albert Postma
    Journal of Renal Nutrition.2024; 34(2): 105.     CrossRef
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    Anthony Pham, Robin Okpara, Nancy Rollins, Roy Jacob
    Cureus.2023;[Epub]     CrossRef
  • Wernicke’s encephalopathy in hyperemesis gravidarum: A systematic review
    Erik Oudman, Jan W. Wijnia, Misha Oey, Mirjam van Dam, Rebecca C. Painter, Albert Postma
    European Journal of Obstetrics & Gynecology and Reproductive Biology.2019; 236: 84.     CrossRef

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