Date: 26 November 2013
22/09/08 This chest radiograph shows bilateral hazy diffuse airspace disease predominating in the lower lungs with subtle nodularity in upper zones.
Copyright: n/a
Notes:
A 33 year old known Chronic Granulomatous Disorder (CGD) male presented to A&E in respiratory distress and admitted with severe bibasal pneumonia. He had been laying mulch in his garden. He had not been taking any prophylactic antifungal agents. Oxygen therapy was commenced in conjunction with IV bacterial and fungal treatment with Amphotericin B (Fungizone ®). Further consultation and an adverse reaction to the administration of Fungizone ® led to a switch to IV Voriconazole 300mg BD. The patient tested positive for aspergillus antibodies in serum. The patient declined a bronchoscopy, responded well to IV voriconazole and was discharged home 2 weeks post admission on maintenance voriconazole.
Images library
-
Title
Legend
-
This photo shows extensive infection of the burn wound on the leg of a 7 year old boy, acquired about 3 weeks after the injury. Despite medical therapy he died.
-
This patient, had had a laparostomy for recurrent intra-abdominal sepsis following on from crohns disease. She was transferred to another intensive care unit and her dressings changed daily. Shortly after, this dark patches appeared on her liver (as seen here A) and her colon. Superficial biopsies and culture showed A.fumigatus invading liver capsule. She responded to amphotericin B therapy.
B shows patient after treatment.
, 
-
Hepatic aspergillosis, pt KO. Repeat CT scan of the liver showing almost complete resolution of lesions on itraconazole therapy.
-
Image A. The CT scan of her abdomen had the appearances shown here. She also has small pulmonary nodules. Bioposy of the liver revealed hyphae consistent with Aspergillus.
Image B. She responded well to oral itraconazole therapy.
, 
-
This image shows the pelvis of the left kidney filled with fungal balls. Eventually, after failing amphotericin B therapy, she required a nephrectomy. Her case is reported in Davies SP, Webb WJS, Patou G, Murray WK, Denning DW. Renal aspergilloma – a case illustrating the problems of medical therapy. Nephrol Dial Transplant 1987; 2: 568-572.
-
Aspergillus keratitis. Good example of Aspergillus keratitis caused by A.glaucus. Usually A.fumitagus and A.flavus are the causes.
, 
