The COVID-19 pandemic and the associated post-acute sequelae of COVID-19 (PASC) have led to the identification of a complex disease phenotype that is associated with important changes in the immune system. Herein, we describe a unique case of Nocardia farcinica cerebral abscess in an individual with sudden immunodeficiency several months after mild COVID-19. Intravenous Bactrim and Imipenem were prescribed for 6 weeks. After this, a 12-month course of Bactrim and Clavulin was prescribed to be taken orally, given the N. farcinica infection at the level of the central nervous system. This case report highlights the need for future research into the pathophysiology of COVID-19 and PASC immune dysregulation in convalescent individuals. It also draws attention to the need for timely consideration of opportunistic infections in patients with a history of COVID-19. https://www.frontiersin.org/articles/10.3389/fneur.2023.1137024/full
"2. Case description A male patient in his 50s with a history of high blood pressure, duodenal ulcer, dyslipidemia, and a history of smoking and alcoholism ...."
I don't think we should put too much emphases on comorbidities when it comes to post Covid complications and infections? Figure 1. (A) Timeline of an episode of care. The patient contracted COVID-19 with mild symptomatology. Thirty days later, the patient was diagnosed with pneumonia and at day 60, presented with hemiparesis. MRI revealed a cerebral lesion. At day 85, the patient presented worsening neurological symptoms and a second MRI showed an additional lesion as well as an increased size of the primary cerebral lesion. At this time, a second biopsy confirmed N. farcinica. (B) MRI imaging showing an abscess involving the high convexity on the right of the frontal lobe measuring ~1.9 cm × 1.7 cm associated with marked adjacent vasogenic edema (a, b). On repeat imaging, an increase in the size (2.9 cm) of the ring enhancing posterior right frontal/anterior parietal lobe is seen, as well as a new ring-enhancing posterior right frontal lobe lesion measuring 1.1 cm, superior to the lesion described prior (c, d).
Confounding sources of immunocompromise ? People with substance use disorders may be at higher risk for SARS-CoV-2 breakthrough infections also: Alcohol and the Immune System - National Institutes of Health
