The most common clinical presentation of Aspergillosis is pulmonary infection. Two cases of other affected organs are reported, one the breast and the other the pleural cavity. The first case regarded a 24 years old female that was admitted in the Surgery Department due to inflammatory mastitis resistant to broad spectrum antibiotic therapy. The cytological and microbiological studies of the breast specimen, collected by fine needle aspiration, detected the presence of Aspergillus, identified as A. fumigatus by culture. She was infected with HIV1 and had a CD4+ T cell count of 16 cell/µL. Good clinical outcome was reached with liposomal AmB therapy, surgical debridement and daily nurse care. The second case concerned a 58 years old male patient that was admitted in the Medicine Department with prolonged fever, cough and bronchopleural fistula. Two years before he had been submitted to left lung resection and chemotherapy because of pulmonary non-small cells lung cancer, stage T1N0M0. There was no evidence of lung cancer and the microbiological studies of sputum and BAL were negative. The direct observation of the residual pleural fluid showed hyphae, identified as Aspergillus fumigatus by culture. Clinical improvement was obtained with pleural drainage, washings with saline and intracavitary instillation of AmB. Simultaneously intravenous liposomal AmB was administered, later changed to oral voriconazole. The rarity and lack of experience in treatment of these clinical presentations of Aspergillosis were the motive for the communication of these two cases.
Full conference title:
The 15 th Congress of the International Society for Human and Animal Mycology
- ISHAM 15th (2003)