# Long-term survival following medical management of Aspergillus endocarditis with dissemination as a consequence of steroid therapy in severe COVID-19 pneumonia

## TL;DR

A man survived a rare and severe fungal infection after receiving steroids for severe COVID-19 pneumonia through aggressive antifungal treatment.

## Contribution

Demonstrates successful long-term medical management of disseminated Aspergillus endocarditis following steroid use in severe COVID-19.

## Key findings

- The patient survived disseminated Aspergillus endocarditis despite its typically poor prognosis.
- Aggressive antifungal therapy with liposomal amphotericin B and voriconazole led to long-term remission.
- The patient is now off antifungal therapy and remains well over two years post-diagnosis.

## Abstract

A male in his 40's with no known comorbidities developed severe COVID-19 pneumonia and received a four-week course of methylprednisolone. The patient subsequently developed disseminated Aspergillus endocarditis, manifesting as multiple organ involvement including the heart, eyes, and brain. Despite the poor prognosis generally associated with fungal endocarditis, the patient survived following aggressive medical management with a combination of liposomal amphotericin b and voriconazole therapy and is now doing well for over two years and is off antifungal therapy for a year.