Tension pneumopericardium: an unusual manifestation of invasive pulmonary aspergillosis

Author:

Müller NL, Miller RR, Ostrow DN, Nelems B, Vickars LM

Date: 3 July 2009

Abstract:

Invasive pulmonary aspergillosis is a necrotizing pneumonitis frequently seen in immunocompromised hosts, particularly patients who have had chemotherapy for lymphoma and leukemia. The Aspergillus characteristically invades branches of the pulmonary artery, leading to thrombosis and hemorrhagic infarction. Radiographic findings include areas of consolidation with or without cavitation. The cavitating lesions may contain loose bodies that represent necrotic lung rather than fungus balls. As the necrotic lung retracts, air fills in the space between the dead tissue and the remaining lung, resulting in the “air crescent” sign on the radiograph. Pulmonary aspergillosis may be associated with bloodstream dissemination of the infection; however, involvement of the heart or pericardium seldom is observed. We describe a case of tension pneumopericardium resulting from invasive pulmonary aspergillosis that developed after bone marrow transplantation in a patient with myelogenous leukemia. At autopsy, there was complete ischemic infarction of the medial basal segment of the left lower lobe, adjoining pleura, and pericardium and a bronchopencardial fistula.

Link to DOI:

Not Known


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