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[A pulmonary mycotic sequestrum during invasive aspergillosis]
1Servicios de Neumología y Hematología, Hospital Clínico Universitario, Valencia.
Anales De Medicina Interna (Madrid, Spain : 1984)
|June 1, 1990
Summary
This study presents two rare cases of mycetomas caused by invasive aspergillosis in leukemia patients with neutropenia. Early diagnosis and treatment with antifungals led to improvement in one patient.
Area of Science:
- Medical Mycology
- Pulmonology
- Hematology
Background:
- Invasive aspergillosis is a serious fungal infection often seen in immunocompromised patients.
- Leukemia and chemotherapy-induced neutropenia significantly increase the risk of opportunistic infections.
- Mycetoma, typically a localized fungal infection, is an unusual presentation of invasive aspergillosis.
Observation:
- Two leukemia patients with neutropenia developed subacute respiratory symptoms including fever, cough, and dyspnea.
- Chest X-rays revealed multiple pulmonary infiltrates with cavitation and fungal hyphae within cysts.
- Precipitin tests identified Aspergillus fumigatus and Aspergillus flavus, confirmed by bronchial brushing specimens.
Findings:
- The cases highlight mycetoma as an exceptional manifestation of invasive aspergillosis.
- Diagnostic workup involved imaging, serological tests (precipitin), and direct specimen analysis.
- One patient demonstrated clinical improvement with antimycotic therapy and neutrophil count recovery.
Implications:
- This presentation expands the spectrum of clinical manifestations for invasive aspergillosis.
- Highlights the importance of considering unusual fungal presentations in neutropenic patients.
- Suggests that prompt diagnosis and targeted antifungal treatment can improve outcomes even in severe cases.