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Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?

Pulmonary aspergillosis causes a wide spectrum of disease, ranging from asymptomatic airway colonization to severe invasive disease, contingent on the host's immune status and underlying pulmonary anatomy. The invasive form of aspergillosis is a rare occurrence in the immunocompetent population...

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Autores principales: Mora Carpio, Andres L., Stempel, Jessica M., de Lima Corvino, Daniela, Garvia, Veronica, Climaco, Antonette
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010647/
https://www.ncbi.nlm.nih.gov/pubmed/29977786
http://dx.doi.org/10.1016/j.rmcr.2018.05.017
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author Mora Carpio, Andres L.
Stempel, Jessica M.
de Lima Corvino, Daniela
Garvia, Veronica
Climaco, Antonette
author_facet Mora Carpio, Andres L.
Stempel, Jessica M.
de Lima Corvino, Daniela
Garvia, Veronica
Climaco, Antonette
author_sort Mora Carpio, Andres L.
collection PubMed
description Pulmonary aspergillosis causes a wide spectrum of disease, ranging from asymptomatic airway colonization to severe invasive disease, contingent on the host's immune status and underlying pulmonary anatomy. The invasive form of aspergillosis is a rare occurrence in the immunocompetent population. Nevertheless, patients with a compromised innate immune response are at greatest risk. We present a case of a patient with known Crohn's disease who developed invasive pulmonary aspergillosis. His clinical picture was further complicated by an uncommon immune response characterized by the development of granulomas encasing the Aspergillus forms found on his lung biopsy, likely representing a maladaptive response, possibly related to the effects of his granulomatous disease in the lungs. He was successfully treated with antifungal therapy and video assisted thoracoscopic surgery with placement of thoracostomy tube drainage for a parapneumonic effusion. We will discuss the factors leading to his atypical presentation and clinical outcome.
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spelling pubmed-60106472018-07-05 Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response? Mora Carpio, Andres L. Stempel, Jessica M. de Lima Corvino, Daniela Garvia, Veronica Climaco, Antonette Respir Med Case Rep Case Report Pulmonary aspergillosis causes a wide spectrum of disease, ranging from asymptomatic airway colonization to severe invasive disease, contingent on the host's immune status and underlying pulmonary anatomy. The invasive form of aspergillosis is a rare occurrence in the immunocompetent population. Nevertheless, patients with a compromised innate immune response are at greatest risk. We present a case of a patient with known Crohn's disease who developed invasive pulmonary aspergillosis. His clinical picture was further complicated by an uncommon immune response characterized by the development of granulomas encasing the Aspergillus forms found on his lung biopsy, likely representing a maladaptive response, possibly related to the effects of his granulomatous disease in the lungs. He was successfully treated with antifungal therapy and video assisted thoracoscopic surgery with placement of thoracostomy tube drainage for a parapneumonic effusion. We will discuss the factors leading to his atypical presentation and clinical outcome. Elsevier 2018-05-16 /pmc/articles/PMC6010647/ /pubmed/29977786 http://dx.doi.org/10.1016/j.rmcr.2018.05.017 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Mora Carpio, Andres L.
Stempel, Jessica M.
de Lima Corvino, Daniela
Garvia, Veronica
Climaco, Antonette
Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?
title Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?
title_full Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?
title_fullStr Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?
title_full_unstemmed Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?
title_short Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?
title_sort granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010647/
https://www.ncbi.nlm.nih.gov/pubmed/29977786
http://dx.doi.org/10.1016/j.rmcr.2018.05.017
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