Ulcerative tracheobronchitis

Date: 26 November 2013

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.

Copyright: n/a

Notes:

This patient was reported in Kramer MR, Denning DW, Marshall SE, Ross D, Berry G, Lewiston N, Stevens DA, Theodore J. Ulcerative tracheobronchitis following lung transplantation: a new form of invasive aspergillosis. Am Rev Resp Dis 1991; 144: 552-556.


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  • Culture plates on different media. A Colonies on CZ at 24oC, B on CYA at 20oC C on SAB at 37oC, D on CYA at 24oC

    persiicolonies

  • D Sinusitis radiology with fluid level

  • C Bronchiectasis white cell scan (right) – left shows a normal scan for comparison

  • B Bronchogram showing bronchiectasis

  • A Bronchogram showing saccular bronchiectasis

  • Mucous containing Charcot-Leyden crystals, stained with H & EA 57 year old woman presented with breathlessness. She had a history of mild asthma for which she occasionally took salbutamol inhaler puffs. The patient underwent a pneumonectomy because of the severity of her disease process, and uncertainty about the diagnosis, prior to serology results being obtained.Serology showed an IgE of 2600, with a strongly positive Aspergillus RAST test and weakly positive Aspergillus precipitins. Material re