Disseminated invasive aspergillosis in an immunocompetent patient

[摘要] A 57-year-old woman was admitted to ourhospital for progressive hypoxic respiratory failure that developed after 10 days of empiric treatment at another hospital for an exacerbation of chronic obstructive pulmonarydisease (COPD). Computed tomography (CT) showed a lesion in the upper lobe of the left lung, withnew ground-glass opacities with cystic andcavitary changes raising concern for an infl ammatory or infectious cause (Figure 1). Respiratory culture of expectorated secretions grewAspergillus. Assays for beta-d-glucan and serumAspergillus immunoglobulin G (IgG) antibodies were positive, although given the improvement in her oxygenation requirements and overall clinical status, these were thought tobe trivial. Tests for immunoglobulin defi ciencies and human immunodefi ciency virus werenegative, ruling out primary immunodefi ciency. However, within the next 48 hours, herrespiratory status declined, and voriconazolewas started out of concern for invasive pulmonary aspergillosis based on results of serumIgG testing.

[学科分类] 卫生学