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Opportunistic pulmonary aspergillosis with chest wall invasion. Plain film and computed tomographic findings
Abstract:
A 37-year-old man with leukemia had the unusual complication of pulmonary aspergillosis eroding through adjacent bone. We were able to demonstrate this on computed tomography (CT) and even on the plain chest film. Bone invasion by an adjacent pulmonary lesion is most often attributed to other organisms or causes. This case demonstrates that aspergillosis must be added to the differential diagnosis of this finding. Recognizing this can be important for the prompt, appropriate treatment of opportunistic infections in the immunocompromised host.
Insights
Pulmonary aspergillosis can erode adjacent bone in immunocompromised patients, a rare complication. This finding, visible on CT and chest X-ray, requires considering fungal infections in the differential diagnosis.
Area of Science:
- Medical imaging
- Infectious diseases
- Oncology
Background:
- Leukemia patients are immunocompromised, increasing susceptibility to opportunistic infections.
- Pulmonary lesions can invade adjacent structures, including bone.
- Aspergillosis is a fungal infection that can affect the lungs.
Observation:
- A 37-year-old leukemia patient presented with pulmonary aspergillosis.
- The aspergillosis eroded through adjacent bone.
- This bone erosion was visualized on computed tomography (CT) and plain chest films.
Findings:
- Pulmonary aspergillosis can cause bone erosion, a previously under-recognized complication.
- This finding is often misattributed to other pathogens or causes.
- Computed tomography (CT) and plain chest films can detect this bone invasion.
Implications:
- Aspergillosis should be included in the differential diagnosis for pulmonary lesions invading bone.
- Early recognition is crucial for timely and effective treatment of opportunistic infections.
- This case highlights the importance of considering fungal infections in immunocompromised hosts with unusual radiographic findings.