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Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
09:52

Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis

Published on: March 9, 2018

A near fatal case of invasive aspergillosis

Gustavo Cumbo-Nacheli1, Jorgelina de Sanctis

  • 1Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, U.S.A.

The American Journal of Case Reports
|April 10, 2013
PubMed
Abstract

Insights

Invasive aspergillosis (IA) can present as endobronchial nodules in patients with systemic lupus erythematosus (SLE). Early recognition and voriconazole treatment led to successful outcomes in a critically ill patient.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Rheumatology

Background:

  • Invasive aspergillosis (IA) rarely manifests with endobronchial nodules or pseudomembranes.
  • Systemic lupus erythematosus (SLE) is an autoimmune condition that can predispose patients to opportunistic infections like IA.
  • Endobronchial lesions on bronchoscopy are an uncommon presentation of IA.

Purpose of the Study:

  • To describe a rare case of IA presenting with endobronchial nodules in a patient with SLE.
  • To emphasize the importance of considering fungal etiology in immunocompromised patients with atypical bronchoscopic findings.
  • To highlight the successful treatment of IA with voriconazole in a critically ill patient.

Main Methods:

  • Case report of a 36-year-old female with SLE who presented with cardiorespiratory shock.
  • Bronchoscopy revealed scattered, white endobronchial nodules.
  • Serologic studies supported the diagnosis of IA.

Main Results:

  • Empiric antifungals were discontinued due to suspicion of fungal disease.
  • Initiation of voriconazole therapy resulted in successful treatment.
  • The patient's condition improved following targeted antifungal therapy.

Conclusions:

  • A high index of suspicion for fungal diseases is crucial in critically ill patients, especially those with endobronchial lesions.
  • Failure to recognize endobronchial patterns of fungal infection can delay treatment and worsen outcomes.
  • This case underscores the need for prompt diagnosis and appropriate antifungal therapy in immunocompromised patients with IA.
Keywords:
endobronchial lesionsinvasive aspergillosissystemic lupus erythematosus

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