Date: 3 February 2014
This patient was 28 yr old with adult lymphocytic leukaemia. She received induction chemotherapy and this infection developed 2 days after recovering from neutropenia.
Copyright:
These images were kindly donated by Maria Cecilia Dignani, MD, Head Infectious Diseases, Fundaleu, Buenos Aires, Argentina. September 2007
(© Fungal Research Trust)
Notes:
A,B,&C the patient had multiple erythematous lesions on the skin, some of the lesions were papular and showed necrotic tissue.
D,E,F & G MRI brain scans showed multiple bilateral nodular lesions in the frontal, parietal and occipital areas. Lesions were 0.7 – 2cm in diameter involving both peripheral and central areas of the brain. G– illustrates a small well defined lesion in the posterior fossa.
H,I & J CT scans of lungs showing nodular lesions in both lungs with infiltrates. I – exhibits the classic halo sign – suggestive of aspergillus infection. J illustrates that some associated pleural effusion was present.
The patient was exposed to high levels of mould during treatment for ALL as a result of a leaking pipe and extensive mould damage to wallcoverings in her home.
Images library
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Drug rashes: Drug interactions between steroids and anti-fungal drugs – (ecchymosis)
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Reference: Muco-cutaneous retinoid effects and facial erythema related to the novel triazole antifungal agent voriconazole. Denning, DW & Griffiths, CEM. Clin.Exp Dermatol 2001, 26(8), 648-53.
Courtesy of Dr D Denning, Wythenshawe Hospital, Manchester.(© Fungal Research Trust),
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Micrographs of A. niger conidia & conidial heads provided by Amaliya Stepanova, Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Micrographs of A. terreus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Patients has history of ABPA complicating long standing asthma. His total IgE has fluctuated between 2,200 and 4,600 KU/L, his Aspergillus IgE between 36.3 and 65.4 kAU/L and Aspergillus IgG from 87-154 mg/L. He has been taking long term itraconazole.
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