Date: 26 November 2013
Recurrent pulmonary shadows 1. 6 Jan 1988 – chest radiograph showing right hilar enlargement, consistent with ABPA.
Recurrent pulmonary shadows 1. 3 Feb 1989 – chest radiograph showing right upper-lobe consolidation and contraction consistent with obstruction of RUL bronchus, in ABPA.
Clearing of pulmonary shadows 3, pt BJ. 5 April 1989 – resolution of shadows seen in February, with a course of corticosteroids.
Recurrence of pulmonary shadows 4, pt BJ. 2 September 1989 – recurrence of pulmonary shadows with an exacerbation of ABPA.
Central bronchiectasis, pt BJ. CT scan of thorax October 1989 showing central bronchiectasis, characteristic of ABPA (and cystic fibrosis).
Copyright: n/a
Notes:
The patient was later treated with itraconazole and reported in Denning DW, Van Wye J, Lewiston NJ, Stevens DA. Adjunctive therapy of allergic bronchopulmonary aspergillosis with itraconazole. Chest 1991; 100: 813-819.
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Images and abstract taken from Mert D et.al., Hematol Rep. 2017 Jun 1;9(2):6997. doi: 10.4081/hr.2017.6997. Invasive Aspergillosis with Disseminated Skin Involvement in a Patient with Acute Myeloid Leukemia: A Rare Case.
Invasive pulmonary aspergillosis is most commonly seen in immunocompromised patients. Besides, skin lesions may also develop due to invasive aspergillosis in those patients. A 49-year-old male patient was diagnosed with acute myeloid leukemia.
The patient developed bullous and zosteriform lesions on the skin after the 21st day of hospitalization. The skin biopsy showed hyphae. Disseminated skin aspergillosis was diagnosed to the patient.
Voricanazole treatment was initiated. The patient was discharged once the lesions started to disappear.
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A pile of woodchip stored for use in a garden usually as a weed suppressing mulch. The heat building up in the pile is illustrated by the plumes of steam eminating from the top of the pile.
Aspergillus fumigatus is particularly well adapted to grow in the heat (up to 60C) found in such piles of rotting organic material and this characteristic, an adaption for its life in its natural environment also enables it to survive and grow in warm mammalian bodies at 37C. Most fungi cannot grow or survive at those temperatures
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MK is 59 years old and presented with right sided pleuritic chest pain and coughing over 1 week. A chest Xray and then CT scan revealed complete collapse of her right lower lobe and middle lobes. Mucous retention is seen just proximal to the abrupt cutoff. There was mild bronchiectasis.
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