Low power microscopy of H&E strained mucus plug

Aspergillus flavus

Aspergillus flavus

Aspergillus flavus

Aspergillus flavus

Aspergillus flavus Link. A colonies after 1 weekB,C conidial heads x 920D Conidia x920 E Conidial head x920

Aspergillus flavus Link. A colonies after 1 weekB,C conidial heads x 920D Conidia x920 E Conidial head x920

Aspergillus cretensis

Conidia

Aspergillus cretensis

Seven-day-old cultures on CYA

Aspergillus cretensis

Conidiophores

Aspergillus clavatus

A colour enhanced image.

Cerebral aspergillosis – CT scans, CLL patient DS.

Patient diagnosed with Stage C Chronic Lymphocytic Leukaemia, treated in the MRC CLL4 study, with prednisolone for 4 weeks followed by oral chlorambucil for 7 days. Patient developed severe pneumonia due to pseudomonas and staphylococcus. Following treatment with broad spectrum antibiotics and 1 week of Abelcet, patient was readmitted with headache, disorientation and fever. CT brain scans showed 3 ring enhancing lesions, aspirated material showed neutrophils but grew aspergillus. Patient now improved on Abelcet (4 mg/kg) and oral itrconazole suspension 200mg b.d.
 
Thanks to Richard Chasty, Consultant Haematologist, North Staffordsire Hospital, UK.

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