Invasive metastasing pulmonary aspergillosis under polychemotherapy

We report on a female patient who received a polychemotherapy because of an extensive pemphigus vulgaris. Under this therapy, the general condition of the patient worsened. Noncharacteristic symptoms, such as dyspnoea and tachycardia occurred. In spite of comprehensive, also invasive diagnostics, pulmonary foci demonstrable by X-ray morphology and computer tomography could not be specified. In the course of treatment, a cerebral compression symptomatology developed. Post mortem, a pulmonary aspergillosis with abscess-formation in the brain was found. The antigen identification completed the diagnosis. The increasing significance of Aspergillus infections is pointed out. The results of clinical examination and the differential diagnosis as well as the possibility of the diagnosis of pulmonary aspergillosis are demonstrated.