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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While invasive pulmonary aspergillosis usually occurs in immunocompromised hosts, it has been described after influenza virus infection in healthy individuals. The first case was a 76-year-old previously healthy woman admitted because of chest pain, cough, sputum, fever, and a chest radiograph abnormality. A transbronchial biopsy specimen showed fungal hyphae. Amphotericin B (AMPH) and Itraconazole (ITCZ) were given, and she improved gradually. A viral test showed a titre of 1/128 to influenza A. Case 2 was a 72-year-old previously healthy man admitted because of cough, fever, chest pain and a consolidation and cavitation on the chest radiograph. Antibiotics were ineffective. Cavitation with a halo sign appeared on the contralateral lung. Because his daughter was infected with Influenza B, we suspected he had been infected with IPA following influenza infection. AMPH and ITCZ and Micafungin sodium were given. His respiratory failure worsened, and on the tenth hospital day he required artificial ventilation; his condition improved gradually, (extubation after 40 days.) A viral test showed a titre of 1/128 to influenza B. IPA must be considered for the differential diagnosis of complications of influenza virus infection.
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PMID:[Two cases of successfully treated invasive pulmonary aspergillosis following influenza virus infection]. 1749 15

This study presents the case of rapidly progressing pulmonary aspergillosis in a 47-year-old woman who had healed cavitations of pulmonary tuberculosis in the right upper lobe. She had been treated for pulmonary tuberculosis seven years prior to admission. The initial manifestations of the disease on admission included cough, dyspnea, hemoptysis, pulmonary infiltrate, and renal failure. As anti-myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) were positive, she was diagnosed with ANCA-associated vasculitis and treated with corticosteroids. This treatment resulted in remission of the vasculitis. However, she developed new pulmonary symptoms and an enlarged cavitary lesion associated with the rapid formation of a fungal, ball-shaped shadow that was serially observed by radiological analysis. Pulmonary resection was finally performed because of acute progressive respiratory failure due to massive recurrent hemoptysis. A subsequent pathological analysis revealed a mass of hyphae with acute-angle branching, features consistent with Aspergillus, within the cavitary lesion, and she was diagnosed with pulmonary aspergillosis. The rapid development of pulmonary aspergillosis associated with the formation of an Aspergillus mycetoma should be attributed to the loss of normal immune mechanisms due to immunosuppressive treatment.
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PMID:Rapid formation of Aspergillus mycetoma in a patient receiving corticosteroid treatment. Serial radiographic observation over two months. 1754 Dec 25

We present a case of chronic necrotising pulmonary aspergillosis (CNPA) successfully diagnosed, treated and followed by ultrathin bronchoscope. A 68-year-old man was admitted to the hospital because of a cough and low-grade fever. A chest computerized tomography (CT) showed cavitary infiltrates in the superior segment of the left upper lobe. Bronchoscopic examination was performed using a 2.8-mm ultrathin bronchoscope, which could be inserted into the cavity lesion under direct vision. Biopsy specimens from a whitish intracavity lesion showed septate-branching hyphae and cultures of the cavital washing grew Aspergillus fumigatus. Using the ultrathin bronchoscope, we instilled amphotericin B into the cavity before oral itraconazole therapy. The patient showed clinical improvement with resolution of the cavitary infiltrates on CT findings. The whitish intracavity lesion had prominently disappeared after 18 months of therapy. An ultrathin bronchoscope is useful for treating and assessing cavity lesions as well as establishing a diagnosis for CNPA patients.
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PMID:Chronic necrotizing pulmonary aspergillosis successfully diagnosed, treated, and followed by ultrathin bronchoscope. 1807 4

Infections caused by Aspergillus spp. in immunocompromised or atopic patients may present as invasive aspergillosis, allergic bronchopulmonary aspergillosis and aspergilloma. In this report a 69 years old female patient admitted to the hospital with the complaints of intermittent cough and sputum and diagnosed as endonbronchial aspergilloma, has been presented. The patient was not immunocompromised, however she has bronchial asthma for 10 years and the disease is now under control. The chest radiography and computed tomography revealed lung infiltration with undefined borders, and bronchoscopy demonstrated the presence of a mass at left lower lobe. In the pathologic examination of biopsy specimen with the use of methenamine silver and PAS methods, hyphae formations concordant with Aspergillus were detected. The direct microscopic examinations of biopsy material and sputum obtained after bronchoscopy, have also revealed the presence of hyphae. A. fumigatus was isolated from the cultures of biopsy material and sputum specimen. The patient was diagnosed as endonbronchial aspergilloma, however the follow-up was failed since she has not accepted medical or surgical treatment. In conclusion, aspergilloma should be considered in the differential diagnosis of mass lesions in the endobronchial area.
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PMID:[A case of endobronchial aspergilloma]. 1844 75

A 71-year-old man was initially given a diagnosis of pulmonary nontuberculous mycobacterial infection due to Mycobacterium intracellulare (M. intracellulare). The patient was admitted because chest roentgenogram and CT scanning showed a progression of infiltrating shadows in the bilateral upper lung fields. Aspergillus fumigatus was identified by bronchial lavage. The patient was found to have chronic necrotizing pulmonary aspergillosis with M. intracellulare and treated with voriconazole (VRCZ). After fifteen days of treatment, he complained of dyspnea and cough. A chest CT showed new diffuse ground glass opacity in the left lower lobe. Arterial blood gas analysis demonstrated severe hypoxemia. Due to concerns about drug-induced lung injury, voriconazole was discontinued and corticosteroid therapy was started. VRCZ was replaced by micafungin. Thereafter, symptoms and left lower shadows resolved. Although the lymphocyte stimulation test for voriconazole was negative, we considered that this pulmonary lesion may have been an adverse reaction to voriconazole.
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PMID:[A suspected case of voriconazole-induced lung injury]. 1851 97

Sudden death due to respiratory pathology is not uncommon and tuberculosis with its complications is well known to cause death. We report a case of a male, train passenger, who started coughing out blood and died on reaching the hospital. Medicolegal autopsy confirmed the sudden unexpected death to be due to pulmonary aspergillosis in the person with past medical history of tuberculosis.
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PMID:Sudden death due to pulmonary aspergillosis. 1906 46

We report a case of pulmonary zygomycosis associated with unusual deposition of calcium salt crystals. The patient was a 75-year-old female who had onset of cough and shortness of breath. She was treated for community-acquired pneumonia but died despite intensive therapy. Postmortem examination revealed diffuse alveolar damage and multifocal necrotizing pneumonia associated with herpes simplex infection and invasive zygomycosis. Birefringent particles were seen associated with fungal elements in the lung parenchyma, within bronchial cartilage, and in blood vessel walls. By infrared spectroscopy, the birefringent particles in the pulmonary parenchyma and within bronchial cartilage had spectral characteristics of calcium oxalate dihydrate and calcium oxalate monohydrate, respectively. The birefringent crystals within vascular walls were identified as calcium carbonate. This case documents the chemical composition and location of 3 different calcium salt crystals in pulmonary zygomycosis. It also shows that among pulmonary fungal infections, calcium oxalate deposition is not restricted to aspergillosis.
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PMID:Deposition of calcium salts in a case of pulmonary zygomycosis: histopathologic and chemical findings. 1945 61

A 23-year old woman with acute biphenotypic leukemia (ABL) complained of chest pain with cough, high fever and hemoptysis during induction chemotherapy, although she had been treated with anti-biotics and micafungin. We made a clinical diagnosis of invasive pulmonary aspergillosis (IPA) based on a consolidation in the right upper lung field on a chest radiograph as well as a high level of serum beta-D-glucan (with no evidence of tuberculosis and candidiasis). We changed her treatment from micafungin to voriconazole. Later, we discovered an air-crescent sign by CT scan that supported the diagnosis of IPA. Following voriconazole treatment, clinical symptoms ceased and abnormal chest shadows improved gradually and concurrently with a recovery of neutrophils. IPA must be considered in immunocompromised patients with pulmonary infiltrates who do not respond to broad-spectrum antibiotics. Serological tests and CT findings can aid in early diagnosis of IPA, which, along with treatment for IPA, will improve clinical outcomes.
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PMID:Successful voriconazole treatment of invasive pulmonary aspergillosis in a patient with acute biphenotypic leukemia. 1972 6

A 61-year-old woman was admitted with a tumor-like lesion in the middle lobe of the right lung which showed substantial uptake on 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET). The chief complaint was dry cough. On the basis of these findings, lung cancer was first to be ruled out. However, subsequent examinations showed Aspergillus fumigatus in sputum and aspergillus-specific IgE and IgG antibodies in the serum. The tumor-like lesion gradually disappeared. Allergic bronchopulmonary aspergillosis without clinical symptom of bronchial asthma was diagnosed with Rosenberg's clinical criteria. The patient's condition stabilized after treatment with inhaled corticosteroid and oral itraconazole. To our knowledge, this is the second report of allergic bronchopulmonary aspergillosis with tumor-like lesions in the lung showing intense 18FDG-PET uptake.
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PMID:[Intense 18F-fluorodeoxyglucose uptake due to allergic bronchopulmonary aspergillosis]. 1990 12

Tuberculous and fungal infections are among the non-neoplastic lesions of the lung, in which fine-needle aspiration cytology (FNAC) has proven to be a useful technique in both immunocompromised and immunocompetent patients. The presence of polymicrobial infection in a renal transplant recipient is documented in the literature, but has rarely been diagnosed on cytology. We report a case of concomitant pulmonary cryptococcosis, aspergillosis, and tuberculosis in a renal transplant recipient diagnosed on FNAC.A 50-year-old renal transplant recipient, asymptomatic for 3 year, presented with intermittent low-grade fever associated with cough, expectoration, and a newly developed cavitatory lesion in the left lung on chest X-ray. Computed tomography-guided FNAC performed on the lung lesion showed fungal profiles with septate hyphae and acute-angled branching consistent with morphology of Aspergillus. In addition, numerous yeast forms of cryptococcus and a few acid-fast mycobacterial tubercle bacilli were seen.Guided FNAC is a useful and reliable technique for the diagnosis of pulmonary infection. One should always keep in mind the possibility of polymicrobial infections especially inimmunocompromised patients.
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PMID:Polymicrobial lung infection in postrenal transplant recipient diagnosed by fine-needle aspiration cytology. 1992 60


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