Date: 26 November 2013
Bilateral upper-lobe cavities in AIDS, pt PC
Copyright: n/a
Notes:
This patient, thought initially to have pulmonary aspergillosis in AIDS, has bilateral upper-lobe cavities, more marked on the left. He presented with fever, nonproductive cough and dyspnoea. Bronchoscopy yielded Aspergillus fumigatus. He refused therapy and died with progressive disease. He is reported as patient 8 in Denning DW, Follansbee S, Scolaro M, Norris S, Edelstein D, Stevens DA. Pulmonary aspergillosis in AIDS. N Engl J Med 1991; 324: 654-662.
Images library
-
Title
Legend
-
Image A
CT Scan 30/3/99
Showing extreme pleural thickening and 2 small cavities at apex of left lung.
-
A 43 year old with smoking related emphysema was admitted to hospital with two separate episodes of haemoptysis. He had been in good health up to 1989, when he was diagnosed as having bilateral pulmonary tuberculosis. At that time a CT scan revealed a cavity in the left upper lobe (20.8cm2) with adjacent confluent infiltrates and pleural thickening. On bronchoscopic examination no abnormalities were noted and endobronchial biopsies did not reveal hyphae.
Over the next 4 years his condition deteriorated and a CT scan showed the left upper lobe cavity had increased to 40cm2. Itraconazole 400mg daily was prescribed. There was some clinical improvement on itraconazole but patient eventually deteriorated with breathlessness and with significant weight loss.
, 
