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Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report

INTRODUCTION: Invasive aspergillosis is a serious complication in immunocompromised patients. It is an opportunistic disease, which predominantly occurs in the lungs, although dissemination to virtually any organ is possible. Invasive aspergillosis in an immunocompetent patient with extension to the...

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Autores principales: Shakoor, Muhammad Tariq, Ayub, Samia, Ayub, Zunaira, Mahmood, Faisal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469364/
https://www.ncbi.nlm.nih.gov/pubmed/22989346
http://dx.doi.org/10.1186/1752-1947-6-311
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author Shakoor, Muhammad Tariq
Ayub, Samia
Ayub, Zunaira
Mahmood, Faisal
author_facet Shakoor, Muhammad Tariq
Ayub, Samia
Ayub, Zunaira
Mahmood, Faisal
author_sort Shakoor, Muhammad Tariq
collection PubMed
description INTRODUCTION: Invasive aspergillosis is a serious complication in immunocompromised patients. It is an opportunistic disease, which predominantly occurs in the lungs, although dissemination to virtually any organ is possible. Invasive aspergillosis in an immunocompetent patient with extension to the mediastinum has rarely been reported. Here, we present the case of a patient with no apparent immunodeficiency state, who presented with Aspergillus endocarditis and fulminant invasive aspergillosis with extensive involvement of the mediastinal structures, which ultimately was responsible for her death. To the best of our knowledge, this is the first reported case in the literature on fulminant invasive mediastinal aspergillosis with extension to the pulmonary vasculature and concomitant Aspergillus endocarditis in an apparently immunocompetent patient without pre-existing lung disease. CASE PRESENTATION: Our patient was a previously healthy 47-year-old Asian woman, who presented to our emergency room with severe progressive shortness of breath of one month’s duration, associated with orthopnea and unstable vital signs. CONCLUSION: Invasive aspergillosis has been described in the presence of pulmonary disease, such as chronic obstructive pulmonary disorder, and one case has been reported in a patient without preexistent disease, but none of these have been fatal. Our case is therefore the first reported case of its kind. Our case shows that fulminant aspergillosis can occur in an immunocompetent host and can be fatal. We conclude that invasive aspergillosis should not be excluded from the differential diagnosis on the basis of immunocompetency.
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spelling pubmed-34693642012-10-12 Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report Shakoor, Muhammad Tariq Ayub, Samia Ayub, Zunaira Mahmood, Faisal J Med Case Rep Case Report INTRODUCTION: Invasive aspergillosis is a serious complication in immunocompromised patients. It is an opportunistic disease, which predominantly occurs in the lungs, although dissemination to virtually any organ is possible. Invasive aspergillosis in an immunocompetent patient with extension to the mediastinum has rarely been reported. Here, we present the case of a patient with no apparent immunodeficiency state, who presented with Aspergillus endocarditis and fulminant invasive aspergillosis with extensive involvement of the mediastinal structures, which ultimately was responsible for her death. To the best of our knowledge, this is the first reported case in the literature on fulminant invasive mediastinal aspergillosis with extension to the pulmonary vasculature and concomitant Aspergillus endocarditis in an apparently immunocompetent patient without pre-existing lung disease. CASE PRESENTATION: Our patient was a previously healthy 47-year-old Asian woman, who presented to our emergency room with severe progressive shortness of breath of one month’s duration, associated with orthopnea and unstable vital signs. CONCLUSION: Invasive aspergillosis has been described in the presence of pulmonary disease, such as chronic obstructive pulmonary disorder, and one case has been reported in a patient without preexistent disease, but none of these have been fatal. Our case is therefore the first reported case of its kind. Our case shows that fulminant aspergillosis can occur in an immunocompetent host and can be fatal. We conclude that invasive aspergillosis should not be excluded from the differential diagnosis on the basis of immunocompetency. BioMed Central 2012-09-18 /pmc/articles/PMC3469364/ /pubmed/22989346 http://dx.doi.org/10.1186/1752-1947-6-311 Text en Copyright ©2012 Shakoor et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Shakoor, Muhammad Tariq
Ayub, Samia
Ayub, Zunaira
Mahmood, Faisal
Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report
title Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report
title_full Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report
title_fullStr Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report
title_full_unstemmed Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report
title_short Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report
title_sort fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469364/
https://www.ncbi.nlm.nih.gov/pubmed/22989346
http://dx.doi.org/10.1186/1752-1947-6-311
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