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Invasive pulmonary aspergillosis: radiologic evidence of tracheal involvement
Abstract:
Chest radiographs of invasive pulmonary aspergillosis in immunocompromised patients typically show ill-defined pulmonary nodules. Direct tracheal involvement has not been previously documented radiologically. Radiographs and CT scans of a 16-year-old boy with aplastic anemia and invasive pulmonary aspergillosis showed increased paratracheal opacity, tracheal narrowing, and pneumomediastinum in combination with pulmonary disease. Bronchial lavage cultures grew Aspergillus fumigatus, and the boy died 24 days later.
Insights
Invasive pulmonary aspergillosis can affect the trachea in immunocompromised patients, a finding not previously seen on imaging. This case highlights direct tracheal involvement in a young patient with aplastic anemia.
Area of Science:
- Medical Imaging
- Pulmonology
- Infectious Diseases
Background:
- Invasive pulmonary aspergillosis commonly affects immunocompromised patients.
- Radiological findings typically include ill-defined pulmonary nodules.
Observation:
- A 16-year-old boy with aplastic anemia presented with invasive pulmonary aspergillosis.
- Imaging revealed increased paratracheal opacity and tracheal narrowing.
Findings:
- Direct tracheal involvement by Aspergillus fumigatus was observed.
- Pneumomediastinum was present alongside pulmonary disease.
Implications:
- This case expands the known radiological manifestations of invasive pulmonary aspergillosis.
- Highlights the importance of considering tracheal involvement in immunocompromised patients with suspected aspergillosis.