2.Allergic Bronchopulmonary Aspergillosis Coupled with Broncholithiasis in a Non-asthmatic Patient.
Won Jung KOH ; Joungho HAN ; Tae Sung KIM ; Kyung Soo LEE ; Hye Won JANG ; O Jung KWON
Journal of Korean Medical Science 2007;22(2):365-368
Allergic bronchopulmonary aspergillosis (ABPA), an asthmatic disease, is caused primarily by hypersensitivity to Aspergillus species. ABPA is rarely observed in the absence of asthma, which is, in fact, the principle criterion for its diagnosis. Here, we report the case of a 36-yr-old woman without a history of bronchial asthma, who manifested a localized pneumonic consolidation, coupled with broncholithiasis. Pathologic examinations of bronchoscopic biopsy specimens and resected surgical specimens revealed features typical of ABPA. This is a very rare case of ABPA coupled with broncholithiasis in a non-asthmatic individual.
Lithiasis/*complications/*diagnosis
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Humans
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Female
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Bronchial Diseases/*complications/*diagnosis
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Asthma
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Aspergillosis, Allergic Bronchopulmonary/*complications/*diagnosis
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Adult
4.Pleural Aspergillosis.
Hyun Cheol CHUNG ; Joon CHANG ; Chul Min AHN ; Sung Kyu KIM ; Won Young LEE ; Doo Yon LEE
Yonsei Medical Journal 1988;29(1):84-88
Pleural aspergillosis is an uncommon disease; only 29 cases have reported in the literature since 1958. We reported a patient with a pleural aspergillosis complicated a preexisting chronic empyema. Treatment consisted of pleuropneumonectomy, creation of an pleurocutaneous window followed by an intrapleural instillation of nystatin.
Aged
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Aspergillosis/diagnosis/*etiology/therapy
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Case Report
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Empyema/complications
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Human
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Lung Diseases, Fungal/diagnosis/*etiology/therapy
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Male
5.Invasive Aspergillosis Arising from Ureteral Aspergilloma.
Hoon CHOI ; Il Sang KANG ; Hun Soo KIM ; Young Hwan LEE ; Ill Young SEO
Yonsei Medical Journal 2011;52(5):866-868
Ureteral obstruction may develop in immunocompromised patients with an Aspergillus fungal infection. Infections can progress to invasive aspergillosis, which is highly lethal. We report a case of a 56-year-old man with alcoholic cirrhosis of the liver and diabetes. He had ureteral aspergilloma, discovered as a saprophytic whitish mass. It was treated by ureteroscopic removal, however, he refused antifungal treatment. His condition progressed to invasive aspergillosis, and died from sepsis and hepatorenal syndrome.
Aspergillosis/diagnosis/*etiology
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Diabetes Complications
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Fatal Outcome
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Humans
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Immunocompromised Host
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Liver Cirrhosis, Alcoholic/complications
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Male
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Middle Aged
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Ureteral Diseases/diagnosis/*etiology
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Ureteral Obstruction/diagnosis/etiology
6.A Case of Chronic Invasive Fungal Sinusitis after Endoscopic Sinus Surgery for Chronic Rhinosinusitis.
Il Woo LEE ; Byung Woo YOON ; Sung Lyong HONG ; Kyu Sup CHO
Korean Journal of Otolaryngology - Head and Neck Surgery 2014;57(7):477-480
Chronic invasive fungal sinusitis is a relatively rare disease that can span from months to years in its clinical course and is described to be more common in immunocompetent patients. Most cases of chronic invasive fungal sinusitis are due to the Aspergillus species and have been treated with a combination of surgery and antifungal agents. However, the incidence is increasing with frequent use of antibiotics, cytotoxic drugs, and systemic corticosteroids. We report a case of chronic invasive fungal sinusitis with orbital complication in the patient who underwent endoscopic sinus surgery for chronic rhinosinusitis. Although chronic invasive fungal sinusitis is relatively rare, it is important for otolaryngologists to be aware of its diagnosis and treatment.
Adrenal Cortex Hormones
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Antibiotics, Antineoplastic
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Antifungal Agents
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Aspergillosis
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Aspergillus
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Diagnosis
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Endoscopy
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Fungi
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Humans
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Incidence
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Orbit
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Postoperative Complications
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Rare Diseases
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Sinusitis*
7.Sudden Atelectasis and Respiratory Failure in a Neutropenic Patient: Atypical Presentation of Pseudomembranous Necrotizing Bronchial Aspergillosis.
Ji Yun NOH ; Seok Jin KIM ; Eun Hae KANG ; Bo Kyoung SEO ; Kyoung Ho RHO ; Yang Seok CHAE ; Byung Soo KIM
The Korean Journal of Internal Medicine 2012;27(4):463-466
Pseudomembranous necrotizing bronchial aspergillosis (PNBA) is a rare form of invasive aspergillosis with a very poor prognosis. The symptoms are non-specific, and the necrotizing plugs cause airway obstruction. Atelectasis and respiratory failure can be the initial manifestations. Recently, we treated an immunocompromised patient with PNBA, who presented with a sudden onset of atelectasis and acute respiratory failure. There were no preceding signs except for a mild cough and one febrile episode. Bronchoscopy revealed PNBA, and Aspergillus nidulans was cultured from the bronchial wash.
Adult
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Female
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Humans
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Immunocompromised Host
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Invasive Pulmonary Aspergillosis/*complications/*diagnosis
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Leukemia, Myeloid, Acute/complications
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Neutropenia/complications
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Pulmonary Atelectasis/*etiology
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Respiratory Insufficiency/*etiology
8.Diagnosis and treatment of invasive pulmonary aspergillosis in malignant hematological diseases-3 cases reported.
Jian-Hui QIAO ; Wan-Jun SUN ; Chang-Lin YU ; Dan-Hong WANG ; Mei GUO ; Shi ZHANG ; Fang LIU ; Hui-Sheng AI
Journal of Experimental Hematology 2003;11(2):202-204
Invasive pulmonary aspergillosis is difficult to diagnose and a critical ill with high mortality. In this paper, the diagnosis and treatment of invasive pulmonary aspergillosis complicated in 3 cases of hematological malignancy (2 acute leukemias and 1 MDS-RA) were retrospectively analysed. All patients had histories of hypoimmunity and were received prophylactic antifungal treatment. Pulmonary aspergillosis infection still occurred and confirmedly diagnosed by sputum examination. After 7 to 14 days of combination treatment of liposomal amphotericin B, itraconazole and flucytosine, 2 cases were cured and another showed effective. In conclusion, early diagnosis and treatment of invasive pulmonary aspergillosis are very critical and the therapeutic effectiveness of combined scheme with liposomal amphotericin B, itraconazole and flucytosine is very effective for pulmonary aspergillosis.
Adult
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Amphotericin B
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therapeutic use
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Anemia, Refractory
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complications
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Aspergillosis
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diagnosis
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drug therapy
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Female
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Humans
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Leukemia
;
complications
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Lung Diseases, Fungal
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diagnosis
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drug therapy
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Male
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Middle Aged
9.Clinical Manifestations and Treatment Outcomes of Pulmonary Aspergilloma.
Sang Hoon LEE ; Byoung Jun LEE ; Do Young JUNG ; Jin Hee KIM ; Dong Suep SOHN ; Jong Wook SHIN ; Jae Yeol KIM ; In Won PARK ; Byoung Whui CHOI
The Korean Journal of Internal Medicine 2004;19(1):38-42
BACKGROUND: Pulmonary aspergilloma usually results from the ingrowth of colonized Aspergillus from a damaged bronchial tree, a pulmonary cyst, or from the cavities of patients with underlying lung diseases. In the present study, we analyzed the clinical features, diagnostic methods, and managements of 36 patients with pulmonary aspergilloma. METHODS: Thirty-six patients were diagnosed as having pulmonary aspergilloma at Chung-Ang University Hospital between February 1988 and February 2000. Their medical records were reviewed retrospectively. RESULTS: The age of patients (median +/- SD) was 53.3 +/- 11.8 years, the male to female ratio was 2.36: 1, and the most frequent symptom was hemoptysis, which occurred in 24 patients (65%). The most common underlying disease was pulmonary tuberculosis (81%), and the upper lobes of both lungs were the most frequently involved sites. Nine patients received a chest CT in the prone position and seven of these showed a movable fungus ball. Eleven patients were positive for the precipitin antibody to A. fumigatus. Twenty patients underwent surgical resection, and post-operative complications were reported in seven cases. The post-operative mortality was 5.6% (2/36). CONCLUSION: Pulmonary aspergilloma usually develops in the patients with underlying lung diseases. Resectional lung surgery is considered the mainstay of therapy for pulmonary aspergilloma. However, this operation is associated with significant complications and death in some cases. Therefore, it is necessary to develop reasonable criteria for selection of candidates for such surgery.
Adult
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Aged
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Aspergillosis/complications/*diagnosis/therapy
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Bronchiectasis/complications
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Diagnosis, Differential
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Female
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Forced Expiratory Volume
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Hemoptysis/etiology
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Human
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Lung Diseases, Fungal/complications/*diagnosis/therapy
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Male
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Middle Aged
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Postoperative Complications/mortality
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Retrospective Studies
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Treatment Outcome
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Tuberculosis, Pulmonary/*complications
10.Case of Pseudomembranous Necrotizing Tracheobronchial Aspergillosis in an Immunocompetent Host.
Hyo Jeong OH ; Hak Ryul KIM ; Ki Eun HWANG ; So Young KIM ; Sun Ho AHN ; Sei Hoon YANG ; Eun Taik JEONG
The Korean Journal of Internal Medicine 2006;21(4):279-282
A 44-year-old Korean male died of rapidly progressive respiratory failure and refractory hypoxemia in 8 days after being admitted with a fever and dyspnea. The patient was diagnosed with pseudomembranous necrotizing tracheobronchial aspergillosis by fibroptic bronchoscopy and it was not related to an invasion of the pulmonary parenchyma. To the best of our knowledge, this case represents a patient with pseudomembranous necrotizing tracheobronchial aspergillosis that developed in an immunocompetent host, rapidly resulting in airway obstruction with acute respiratory failure and refractory hypoxemia without an invasion of the pulmonary parenchyma.
Tracheitis/complications/diagnosis/*immunology
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Tomography, X-Ray Computed
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Respiratory Insufficiency/diagnosis/etiology
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Necrosis/complications/diagnosis/immunology
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Male
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*Immunocompromised Host
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Humans
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Fatal Outcome
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Diagnosis, Differential
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Bronchoscopy
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Bronchitis/diagnosis/*immunology/radiography
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Biopsy
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Aspergillosis/complications/diagnosis/*immunology
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Adult