CGD patient who developed mulch pneumonitis

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.

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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.

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Aspergillus westerdijkiae

Seven-day-old cultures on A CYA
Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.A,B Thoracic airsac (T) with prominent blood vessels and a dead serratospiculum worm (W). The presence of these lung worms makes the airsac look milky. D N

Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.A,B Thoracic airsac (T) with prominent blood vessels and a dead serratospiculum worm (W). The presence of these lung worms makes the airsac look milky. D Normal ovary with developing follicles.
Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.B,D Aspergillus lesions (A) over a swollen liver

Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.B,D Aspergillus lesions (A) over a swollen liver
Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.B Cranial, middle, caudal lobes (K1,K2,K3) of the left kidney, all the lobes show slight nephromegaly.C Yellow aspergillus colony (A1), lying adjacent to the

Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.B Cranial, middle, caudal lobes (K1,K2,K3) of the left kidney, all the lobes show slight nephromegaly.C Yellow aspergillus colony (A1), lying adjacent to the lung.D White aspergillus colonies (A2,A3,A4).
Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.C Cranial pole of left kidney (K) -mildly inflamed.D Ovary ( F) with developing follicles.

Falcons: The following images were obtained by endoscopy of falcons with aspergillosis.C Cranial pole of left kidney (K) -mildly inflamed.D Ovary ( F) with developing follicles.
The following images were obtained by endoscopy of falcons with aspergillosis.A and B Lung Worm (S) over liver (Li) (serratospiculum seurati)C and D Aspergilloma (A) and prominent blood vessels on the caudal thoracic air sac (T).

The following images were obtained by endoscopy of falcons with aspergillosis.A and B Lung Worm (S) over liver (Li) (serratospiculum seurati)C and D Aspergilloma (A) and prominent blood vessels on the caudal thoracic air sac (T).