Aspergilloma refers to a fungal ball formed by saprophytic overgrowth of Aspergillus species and is seen secondary to cavitatory/cystic respiratory diseases. Paucity of clinical and pathological data of aspergilloma in India prompted us to analyze cases of aspergilloma over 15 years. The clinical features were recorded in all and correlated with detailed pathological examination. Aspergillomas were identified in 41 surgical excisions or at autopsy. There was male predominance; half the patients were in their fourth decade. Episodic hemoptysis was the commonest mode of presentation (85.4%). Forty aspergillomas were complex, occurring in cavitatory lesions (82.9%) or in bronchiectasis (14.6%). Simple aspergilloma was seen as an incidental finding in only one. Tuberculosis was the etiological factor in 31 patients, producing cavitatory or bronchiectatic lesions; other causes were chronic lung abscess and bronchiectasis (unrelated to tuberculosis). Surgical resections are endorsed in view of high risk of unpredictable, life-threatening hemoptysis. (+info)
Rhinocerebral zygomycosis with pulmonary aspergillosis in a non-HIV-infected patient: an unusual case report from India.
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Bronchoalveolar lavage as a diagnostic tool in patients with hematological malignancies and pneumonia.
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We report our experience concerning bronchoalveolar lavage (BAL) in adult patients affected by haematological malignancies. BAL was performed in patients with documented pulmonary diseases not responding to empirical antibiotic and antifungal therapies. Overall, 25 bronchoscopies were performed in 24 patients. This technique led to pathogen identification in 11 out of 24 patients (45 percent). In particular, we identified four cases of tuberculosis, four of aspergillosis, two of pneumocystosis, two bacterial pneumonia and one pneumonia sustained by CMV (in two cases, pneumonia was polymicrobial). In three cases, where microbiological diagnosis had been obtained by means of other exams (blood culture, urinary antigens), BAL negativity allowed us to exclude alternative diagnoses. Pulmonary location of haematological disease was diagnosed in seven patients. BAL drove a switch therapy in 54 percent of patients. When performed by expert operators, BAL is useful and safe also in frail patients, such as those affected by onco-haematological malignancies. (+info)
Aspergillus fumigatus metabolism: clues to mechanisms of in vivo fungal growth and virulence.
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Combination therapy in treatment of experimental pulmonary aspergillosis: in vitro and in vivo correlations of the concentration- and dose- dependent interactions between anidulafungin and voriconazole by Bliss independence drug interaction analysis.
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Aspergillus vertebral osteomyelitis and epidural abscess.
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We present the first reported case of Aspergillus vertebral osteomyelitis and epidural abscess in Singapore in a 50-year-old man with post-tuberculous bronchiectasis. The patient presented with acute urinary retention and flaccid paraplegia. Despite surgical debridement and treatment with voriconazole, the patient developed multiorgan failure and died two weeks after presentation. Early diagnosis and prompt initiation of treatment are emphasised in the hope of improving the outcome of this aggressive condition. (+info)
Mycotic pododermatitis and mycotic pneumonia in commercial turkey poults in northern California.
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Seven 5-week-old broad-breasted white commercial meat turkeys were submitted to the California Animal Health and Food Safety laboratory in Turlock with a history of respiratory illness. The primary diagnostic findings were mycotic pododermatitis and mycotic pneumonia. The unique feature of this case was the colonization of footpad epidermis and subcutis by fungal hyphae in commercial turkey species. No fungal cultures were undertaken at the time of the necropsy; therefore, paraffin-embedded tissue sections of lung and footpads were used to extract, amplify, and sequence mycotic DNA. A mixed population of fungi was identified in both lung and footpads by polymerase chain reaction amplification of part of the large subunit ribosomal RNA gene using broad-range fungal primers and DNA sequencing. In footpads, sequences matching Cryptococcus saitoi and Cladosporium and Cudoniella species were identified. It is believed that these fungi were opportunistic pathogens originating from the litter. The fungi identified from lungs were Aspergillus species, most closely matching Aspergillus flavus and Arxiozyma telluris (most likely a contaminant). Mycotic pododermatitis in avian species is considered a rare pathologic finding, and few documented reports are available. The on-farm prevalence of footpad lesions was estimated at 3%, and there was no associated increase in the incidence of lameness or weight depression in affected birds. Microscopically, a granulomatous inflammatory reaction associated with fungal hyphae was observed in lung parenchyma. Disruption of keratinized epidermis, encrustations, and acute inflammation were also noted in footpads invaded with fungal hyphae. (+info)