Pseudomembranous Aspergillus tracheobronchitis

Date: 26 November 2013

Pt FT. Autopsy appearance of the trachea, after the adherent pseudomembrane had been removed, revealing confluent ulceration superiorly with small green plaques of Aspergillus growth on the trachea inferiorly.

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Notes:

This patient had an acute onset of neutropenia, of undetermined origin, which was treated with prednisolone, before developing rapidly progressive and ultimately fatal pseudomembranous Aspergillus tracheobronchitis. His case was reported because he developed a unilateral monophonic wheeze, which prompted a diagnostic bronchoscopy.Tait RC, O’Driscoll BR, Denning DW. Unilateral wheeze due to pseudomembranous Aspergillus tracheobronchitis in the immunocompromised patient. Thorax 1993; 48: 1285-1287. Disseminated aspergillosis was found at autopsy and cultures from each organ were found to be clonal (Birch M, Nolard N, Shankland G, Denning DW. DNA typing of epidemiologically-related isolates of Aspergillus fumigatus. Infect Epidemiol 1995; 114: 161-168.)


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Showing 10 posts of 2509 posts found.
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  • A pile of woodchip stored for use in a garden usually as a weed suppressing mulch. The heat building up in the pile is illustrated by the plumes of steam eminating from the top of the pile.

    Aspergillus fumigatus is particularly well adapted to grow in the heat (up to 60C) found in such piles of rotting organic material and this characteristic, an adaption for its life in its natural environment also enables it to survive and grow in warm mammalian bodies at 37C. Most fungi cannot grow or survive at those temperatures

    Image 1, Image 2, Image 3, Image 4. Note visible mould growth.

  • MK is 59 years old and presented with right sided pleuritic chest pain and coughing over 1 week. A chest Xray and then CT scan revealed complete collapse of her right lower lobe and middle lobes. Mucous retention is seen just proximal to the abrupt cutoff. There was mild bronchiectasis. 

    October 2016, January 2017

  • Drug rashes: Drug interactions between steroids and anti-fungal drugs – (ecchymosis)

    Image A: Red skin rash on arms due to effect of inhaled steroids termed ecchymosis., Image B: Red skin rash on arms due to effect of inhaled steroids termed ecchymosis., Image C: Papular rash with blisters on the back, associated with CPA but prior to treatment, rash appeared 2 years previously in October 2007. The rash resolved on treatment with azoles., Image D: Papular rash with blisters on the back, associated with CPA but prior to treatment, rash appeared 2 years previously in October 2007. The rash resolved on treatment with azoles.

  • Reference: Muco-cutaneous retinoid effects and facial erythema related to the novel triazole antifungal agent voriconazole. Denning, DW & Griffiths, CEM. Clin.Exp Dermatol 2001, 26(8), 648-53.
    Courtesy of Dr D Denning, Wythenshawe Hospital, Manchester.(© Fungal Research Trust)

    Patient AB: Voriconazole rash. Following 8 weeks of Voriconazole, patient had remarkable facial erythema, most consistent with sun exposure because of sparing of her neck., Patient AB: Voriconazole rash. Following 8 weeks of Voriconazole, patient had remarkable facial erythema, most consistent with sun exposure because of sparing of her neck., Patient AB: Discoid lupus erythematosus following 12 months voriconazole therapy. This improved with use of sunblock factor 30 and resolved after discontinuation of voriconazole, 2 months later.

  • Micrographs of A. niger conidia & conidial heads provided by Amaliya Stepanova, Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.

    A niger conidial head TEM in vitro (РКПГF-1124), A niger mature conidium TEM in vitro (РКПГF-1124)

  • Micrographs of A. terreus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.

    A terreus aleurospore TEM in vitro (РКПГF-1275), A terreus mature conidium SEM in vitro (РКПГ-1275), A terreus mature conidial head SEM in vitro

  • Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.

    Conidial head (SEM), Part of conidial head (SEM), Mature conidia (SEM), Hyphae (SEM), Murine lung tissue (TEM)


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