Date: 26 November 2013
Further details
Image 5. Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with 3 weeks off between successive pulses, for four pulses) and treatment was successful.
Copyright:
Image 1. Copyright Fungal Research Trust.
Image 2. Copyright B.Flannigan, R Samson & JD Miller (From Microorganisms in home and indoor work environments, Published by Taylor and Francis)
Images 3-5. With thanks to S Veraldi, A Chiaratti and H Harak Institute of Dermatological Sciences, University of Milan. Italy . These images remain the copyright of ‘Mycoses’ where the full article may be viewed. (Veraldi et al, published online Mycoses, 5th May 2009 http://www3.interscience.wiley.com/cgi-bin/fulltext/122374087/HTMLSTART).
Notes: n/a
Images library
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Pt FT. Autopsy appearance of the trachea, after the adherent pseudomembrane had been removed, revealing confluent ulceration superiorly with small green plaques of Aspergillus growth on the trachea inferiorly.
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This view was obtained in a lung transplant recipient at bronchoscopy. Aspergillus fumigatus was grown from bronchial lavage but invasion was not demonstrated on bronchial biopsy. Symptoms improved with itraconazole therapy and abnormal appearances had resolved within 2 weeks.
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Bronchoscopic view of Aspergillus tracheobronchitis. Bronchial lavage revealed hyphae in microscopy and cultures grew A.fumigatus. This man had received a lung transplant a few weeks before. Invasion of mucosa, but not cartilage, was demonstrated histologically. He responded rapidly to oral itraconazole.
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This view from indirect laryngoscopy illustrates bilateral lesions on the larynx that on biopsy were shown to be due to Aspergillus. This is a rare disease in non-immunocompromised patients.
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Bronchoscopic view of a deep bronchial ulcer in a lung transplant patient. Biopsies through the ulcer yielded cartilage with hyphae invading it. Fungal cultures of bronchial lavage grew Aspergillus fumigatus. He responded to oral itraconazole therapy.
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Patient had life threatening pneumonia, cavity formation was later observed. He later presented with a fungal ball. The aspergilloma was removed by surgical resection of the right upper lobe.
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