EM@3AM: High Priority Fungal Pathogens and Empiric Treatment in the ED
A 65-year-old male with a past medical history of chronic obstructive pulmonary disease on 2 liters per minute (LPM) nasal cannula at baseline, hypertension, hyperlipidemia, and polypectomy presents to the ED with 2 days of worsening shortness of breath, pleuritic chest pain, persistent fevers, and productive coughs with occasional hemoptysis. He reported having a COVID-19 infection 3 weeks ago but felt better 1-2 weeks ago. Four days ago, he presented to the ED for a COPD exacerbation. He is on his last day of a 5-day course of azithromycin 250 mg and prednisone 40 mg. He is compliant with his home medications including albuterol and inhaled corticosteroids. He is a retired farmer who lives with his wife and pet dog at home. On chart review, a sputum culture collected during a recent hospital visit grew a species of Aspergillus.
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