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Immune reconstitution syndrome (mucous impaction or obstructing bronchial aspergillosis) complicating pulmonary aspergillosis in AIDS. Chest X ray (+day 42) Immune reconstitution syndrome
Immune reconstitution syndrome Immune reconstitution syndrome (mucous impaction or obstructing bronchial aspergillosis) complicating pulmonary aspergillosis in AIDS. Chest X ray (+day 42)

Chest x-rays: Patient 58 years old with AIDS

This case was published in Eur J Clin Microbiol Infect Dis. 2005 Sep;24(9):628-33. 

(Invasive pulmonary aspergillosis transformed into fatal mucous impaction by immune reconstitution in an AIDS patient. By Samabatakou H; Denning D). PubMed Link.

Immune reconstitution syndrome (mucous impaction or obstructing bronchial aspergillosis) complicating pulmonary aspergillosis in AIDS Chest X ray (+day 14) Chest X ray (+day 14)
Chest X ray (+day 14) Immune reconstitution syndrome (mucous impaction or obstructing bronchial aspergillosis) complicating pulmonary aspergillosis in AIDS Chest X ray (+day 14)

Chest x-rays: Patient 58 years old with AIDS

This case was published in Eur J Clin Microbiol Infect Dis. 2005 Sep;24(9):628-33. 

(Invasive pulmonary aspergillosis transformed into fatal mucous impaction by immune reconstitution in an AIDS patient. By Samabatakou H; Denning D). PubMed Link.

Orbital aspergillosis with late fungemia Case 43, ptSW Orbital aspergillosis with late fungemia
Chronic fibrosing pulmonary aspergillosis Chronic fibrosing pulmonary aspergillosis pt RS.
Chronic fibrosing pulmonary aspergillosis Chronic fibrosing pulmonary aspergillosis pt RS.
Pleural thickening followed by CNPA Image G. 14/5/99 Showing progression of the cavity with some debris inside 14/5/99 Showing progression of the cavity with some debris inside
14/5/99 Showing progression of the cavity with some debris inside Pleural thickening followed by CNPA Image G. 14/5/99 Showing progression of the cavity with some debris inside

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA Image F. 14/5/99 Compare with B, showing progressive enlargement of cavity and formation of fungal ball. 14/5/99 Compare with B, showing progressive enlargement of cavity and formation of fungal ball.
14/5/99 Compare with B, showing progressive enlargement of cavity and formation of fungal ball. Pleural thickening followed by CNPA Image F. 14/5/99 Compare with B, showing progressive enlargement of cavity and formation of fungal ball.

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA Image E 14/5/99 Showing enlargement of cavity at left apex and formation of a new cavity there.
Pleural thickening followed by CNPA Image E 14/5/99 Showing enlargement of cavity at left apex and formation of a new cavity there.

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA Image D 30/3/99 One medium sized irregular cavity at left apex
Pleural thickening followed by CNPA Image D 30/3/99 One medium sized irregular cavity at left apex

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA Image C. 30/3/99 Parenchymal or pleural disease adjacent to the mediasternum on the left with diffuse parenchymal disease. Also pleural based nodules bilaterally.  30/3/99 Parenchymal or pleural disease adjacent to the mediasternum on the left with diffuse parenchymal disease.
 30/3/99 Parenchymal or pleural disease adjacent to the mediasternum on the left with diffuse parenchymal disease. Pleural thickening followed by CNPA Image C. 30/3/99 Parenchymal or pleural disease adjacent to the mediasternum on the left with diffuse parenchymal disease. Also pleural based nodules bilaterally.

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA Image B 30/3/99 Note one small cavity at apex of left lung 30/3/99 Note one small cavity at apex of left lung
30/3/99 Note one small cavity at apex of left lung Pleural thickening followed by CNPA Image B 30/3/99 Note one small cavity at apex of left lung

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA Image A CT Scan 30/3/99 Showing extreme pleural thickening and 2 small cavities at apex of left lung.
Pleural thickening followed by CNPA Image A CT Scan 30/3/99 Showing extreme pleural thickening and 2 small cavities at apex of left lung.

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA 7/5/99 (left side)
Pleural thickening followed by CNPA 7/5/99 (left side)

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA 6/1/99(left side) 6/1/99(left side)
6/1/99(left side) Pleural thickening followed by CNPA 6/1/99(left side)

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Pleural thickening followed by CNPA Chest X-ray 18/8/99 (left side) Chest X-ray  18/8/99 (left side)
Chest X-ray  18/8/99 (left side) Pleural thickening followed by CNPA Chest X-ray 18/8/99 (left side)

Case 012 Pleural thickening followed by Chronic Pulmonary Necrotising Aspergillosis- worsened by steroids, then surgery.

Finger clubbing and COPD
Finger clubbing and COPD

This 73 year old patient with CPA in right upper lobe and COPD who was also a heavy smoker, showed evidence of finger clubbing ( A,B,C). He has been on long term itraconazole, in 1990 he had an oesophagectomy for cancer of the oesophagus. Finger clubbing is an uncommon symptom only seen in advanced or chronic disease. D, chest X ray there are background changes nof COPD with loss of volume in the right hemithorax and a right apical cavititating lesion.

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