Secondary metabolites, structure diagram: Trivial name – fumigaclavine C

Pseudomembranous Aspergillus tracheobronchitis

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.

Non invasive Aspergillus bronchitis

This view was obtained in a lung transplant recipient at bronchoscopy. Aspergillus fumigatus was grown from bronchial lavage but invasion was not demonstrated on bronchial biopsy. Symptoms improved with itraconazole therapy and abnormal appearances had resolved within 2 weeks.

Aspergillus tracheobronchitis

Bronchoscopic view of Aspergillus tracheobronchitis. Bronchial lavage revealed hyphae in microscopy and cultures grew A.fumigatus. This man had received a lung transplant a few weeks before. Invasion of mucosa, but not cartilage, was demonstrated histologically. He responded rapidly to oral itraconazole.

Laryngeal aspergillosis

This view from indirect laryngoscopy illustrates bilateral lesions on the larynx that on biopsy were shown to be due to Aspergillus. This is a rare disease in non-immunocompromised patients.

Ulcerative tracheobronchitis

Bronchoscopic view of a deep bronchial ulcer in a lung transplant patient. Biopsies through the ulcer yielded cartilage with hyphae invading it. Fungal cultures of bronchial lavage grew Aspergillus fumigatus. He responded to oral itraconazole therapy.

pt NM aspergilloma with cavities following pneumonia

Patient had life threatening pneumonia, cavity formation was later observed. He later presented with a fungal ball. The aspergilloma was removed by surgical resection of the right upper lobe.

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