IPA in late stage AIDS

Date: 26 November 2013

IPA in late stage AIDS, pt TB

Copyright: n/a

Notes:

Close up of cavity of left upper-lobe, proven to be invasive pulmonary aspergillosis at autopsy.

Pulmonary aspergillosis in a patient who had AIDS for 3 years (CD4 count. <10/mm3). Right middle-lobe consolidation and a left upper-lobe cavity as seen in a previously normal lung; the diagnosis was made by culture of a bronchoalveolar lavage specimen and was confirmed at autopsy. (This was published in (Khoo S, Denning DW. Aspergillus infection in the acquired immune deficiency syndrome. Clin Infect Dis 1994; 19 (suppl 1): S41-48.)


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  • Culture plates on different media. A Colonies on CZ at 24oC, B on CYA at 20oC C on SAB at 37oC, D on CYA at 24oC

    persiicolonies

  • D Sinusitis radiology with fluid level

  • C Bronchiectasis white cell scan (right) – left shows a normal scan for comparison

  • B Bronchogram showing bronchiectasis

  • A Bronchogram showing saccular bronchiectasis

  • Mucous containing Charcot-Leyden crystals, stained with H & EA 57 year old woman presented with breathlessness. She had a history of mild asthma for which she occasionally took salbutamol inhaler puffs. The patient underwent a pneumonectomy because of the severity of her disease process, and uncertainty about the diagnosis, prior to serology results being obtained.Serology showed an IgE of 2600, with a strongly positive Aspergillus RAST test and weakly positive Aspergillus precipitins. Material re