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Published on: March 17, 2014
Pseudomembranous tracheobronchitis caused by Aspergillus
D W Hines1, M H Haber, L Yaremko
1Department of Medicine and Pathology, Rush Presbyterian-St. Luke's Hospital, Chicago, Illinois.
Abstract:
Four immunosuppressed patients with a rapidly evolving, febrile, respiratory distress syndrome were found at autopsy to have Aspergillus pseudomembranes of their lower tracheobronchial tree. Steroids, neutropenia, broad spectrum antibiotic use, and alcoholism appear to be predisposing risk factors. Bronchoscopy may reveal the pathology but antemortem diagnosis is difficult because of the low yield of sputum cultures and fulminant nature of the disease.
Insights
Four immunosuppressed patients developed severe respiratory distress due to Aspergillus pseudomembranes in their lower airways. Early diagnosis is challenging due to the aggressive nature of this invasive fungal infection.
Area of Science:
- Pulmonology
- Infectious Diseases
- Mycology
Background:
- Invasive fungal infections pose a significant threat to immunocompromised individuals.
- Rapidly progressive respiratory failure necessitates prompt diagnosis and management.
Observation:
- Autopsy revealed Aspergillus pseudomembranes in the lower tracheobronchial tree of four patients.
- Patients presented with febrile, rapidly evolving respiratory distress syndrome.
Findings:
- Predisposing factors included steroid use, neutropenia, broad-spectrum antibiotics, and alcoholism.
- Antemortem diagnosis is difficult due to low sputum culture yield and disease fulminance.
Implications:
- Highlights the critical need for heightened clinical suspicion for invasive aspergillosis in at-risk patients.
- Suggests that bronchoscopy may be a valuable diagnostic tool.
- Underscores the challenges in early detection and treatment of this severe fungal complication.
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