Colonization of an intralobar pulmonary sequestration by Aspergillus

Area of Science:

• Medical Mycology
• Pulmonology
• Infectious Diseases

Background:

• Aspergillus is an opportunistic fungus that typically colonizes pre-existing lung cavities, particularly tuberculous ones.
• Infection of a pulmonary sequestration by Aspergillus is exceptionally rare, with limited documented cases globally.
• Pulmonary sequestration, a congenital lung malformation, can serve as a nidus for unusual infections.

Purpose of the Study:

• To report an unusual case of Aspergillus fumigatus infection within a pulmonary sequestration.
• To highlight the diagnostic challenges and successful management of this rare clinical presentation.
• To contribute to the limited world literature on fungal colonization of pulmonary sequestrations.

Main Methods:

• A case study of a 48-year-old woman presenting with pleuritic chest pain.
• Diagnostic imaging including chest radiology and computed tomography (CT) for mass characterization.
• Microbiological analysis involving aspiration puncture for pus examination and fungal culture.
• Surgical intervention (lobectomy) for definitive treatment.

Main Results:

• Chest radiology and CT revealed a 6 x 5-cm hypodense mass in the lower right lobe, suggestive of an infected sequestration.
• Microscopic examination and culture confirmed Aspergillus fumigatus as the causative agent.
• Surgical resection of the infected pulmonary sequestration was successfully performed.

Conclusions:

• Aspergillus fumigatus can exceptionally colonize and infect pulmonary sequestrations.
• Multimodal diagnostic approaches, including imaging and microbiology, are essential for identifying this rare condition.
• Surgical resection remains the primary treatment for infected pulmonary sequestrations caused by Aspergillus.