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An unusual example of Aspergillus species lung disease

R L Pardy1, M Grymaloski, B A Walker

  • 1St Paul's Hospital and The University of British Columbia, Vancouver, Canada.

Canadian Respiratory Journal
|December 26, 2001
PubMed

Insights

Persistent hemoptysis following a gunshot wound was linked to Aspergillus infection within retained bullet fragments. Surgical removal of infected fragments and lung tissue resolved the bleeding in this unique case.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Trauma Surgery

Background:

  • Gunshot wounds to the thorax can lead to complex thoracic injuries.
  • Persistent hemoptysis is a serious complication requiring thorough investigation.
  • Fungal infections, such as Aspergillus, can occur in the context of retained foreign bodies.

Observation:

  • A 37-year-old male presented with persistent hemoptysis after a gunshot wound to the right shoulder and lung.
  • Imaging revealed retained bullet fragments within the lung parenchyma.
  • A right upper lobectomy was performed for management of the hemoptysis and associated lung injury.

Findings:

  • Aspergillus species microorganisms were identified within the retained bullet fragments during pathological examination.
  • The infected bullet fragments are implicated as the source of the fungal infection.
  • The presence of fungal elements within foreign material highlights a potential pathway for chronic infection.

Implications:

  • Retained bullet fragments can serve as a nidus for chronic fungal infections, leading to significant complications like hemoptysis.
  • This case underscores the importance of considering and investigating infected foreign bodies in patients with persistent hemoptysis after penetrating trauma.
  • Management strategies may need to include aggressive debridement and removal of infected foreign material to resolve such complications.

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