Date: 26 November 2013
Born 75 years ago, Pt HK had 3 episodes of tuberculosis as a child and teenager, being treated with PAS and streptomycin. He suffered a ‘bad chest’ all his life and retired aged 54. Presenting with worsening and more frequent chest infections, he was referred with ‘bronchiectasis and Aspergillus sensitisation’. A diagnosis of chronic pulmonary aspergillosis was made in June 2009 on the basis of his chest radiograph and strongly positive Aspergillus precipitins (IgG antibodies) (titre 1/16). He also had Pseudomonas aeruginosa colonisation. His oxygen saturation was 87% and his pO2 6.8, pCO2 6.2 KPa.
His chest radiograph (see above, November 2009) was reported as showing; “ The lung fields are over-inflated. Bilateral apical fibrotic change secondary to old TB. No cavity seen.” At clinic, bilateral apical cavities were seen, with some associated pleural thickening at the left apex, without any evidence of a fungal ball.
He started posaconazole 400mg twice daily with therapeutic levels at subsequent visits. Sputum cultures never grew Aspergillus. Over the following 9 months he had no chest infections requiring antibiotics, his breathlessness worsened gradually and he remained easily fatigued. His Aspergillus antibody titres fell. Overall he felt better, but was concerned about declining respiratory status.
Copyright:
Fungal Research Trust
Notes: n/a
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Aspergillosis in the coral sea fan Gorgonia ventalina. Sea fan coral Gorgonia ventalina, Florida Keys, USA. Depth ~5 metres, showing a lesion surrounded by a band of purple tissue. Central areas of the lesion are devoid of coral tissue revealing the underlying axial skeleton. The purple areas are devoid of coral polyps and result from the increased production of purple sclerites (small, non-fused, carbonate skeletal elements). The purpled area also indicates the location of high fungal hyphal density and el
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Aspergillosis in the coral sea fan Gorgonia ventalina. In the Caribbean ond offshore USA the sea fan coral species Gorgonia ventalina is undergoing an epizootic due to Aspergillus sydowii infection. This species of Aspergillus is also known to be associated with food contamination and for opportunistic infection in humans.Taken in San Salvador, Bahamas. Bar represents 5cm. This sea fan was heavily colonized by algae.A -tumours and galls B -lesion C -purplingGalls are composed of axial skeleton and scl
