Date: 26 November 2013
These pictures show remarkable curvature of the spine as a result of collapse of the vertebral bodies of the thoracic vertebrae. This is a gross example of steroid-induced osteoporosis. The dose was not large in the last 10 years, typically 5-10mg daily, but multiple high dose courses and slow tapering lead to this outcome.
Her corticosteroid warning card is also demonstrated, as additional steroids are required for any significant illness or surgery, as her adrenal glands had completely atrophied.
Kindly supplied by Prof David Denning, South Manchester University Hospitals NHS Trust, Manchester UK
(© Fungal Research Trust)
Copyright:
Kindly supplied by Prof David Denning, South Manchester University Hospitals NHS Trust, Manchester UK
Notes:
Images library
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Patient MB X rays and CT scans. Chronic calcified maxillary sinusitis, patient had a palate defect.A. fumigatus cultured.
Images A&B Plain X rays antero-posterior and lateral, pre-operatively of Pt MB aged 76 who presented with unilateral nasal stuffiness and difficulty getting dentures fitted. She had hda these symptoms for many years. A large irregular calcified mass can be seen replacing the right maxillary sinus.
Images C D & E Coronal CT scan images of Pt MB showing a completely obstructed nasal cavity bilaterally and loss of internal nasal architecture. On the right side is large lamellar calcified lesion embedded in the extensive inflammatory material. Loss of bony margins is seen in numerous locations. This material was all removed surgically and showed mostly necrotic debris with Charcot-Leyden crystals and a few eosinophils and degenerate fungal hyphae. Aspergillus fumigatus was cultured from the material, especially infero-laterally on the right.
Image F Photograph through the mouth post-operatively showing the palate and a large defect in its right side. Through the defect can be seen the interior of the right maxillary sinus and nasal cavity with the inferior turbinate just visible.
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Aspergillus keratitis. Severe aspergillus infection with large area of corneal ulceration and deep stromal involvement
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery.
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery.
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery.
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery
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Aspergillus keratitis. Shrunken eye as a consequence of this infection
 due to long term steroid use){kind=link}