Cargando…
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...
Autores principales: | , , , , |
---|---|
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 |
_version_ | 1783333626076725248 |
---|---|
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. |
format | Online Article Text |
id | pubmed-6010647 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT moracarpioandresl granulomatousresponsetoinvasivepulmonaryaspergillosisinanimmunotherapynaivehostamaladaptiveresponse AT stempeljessicam granulomatousresponsetoinvasivepulmonaryaspergillosisinanimmunotherapynaivehostamaladaptiveresponse AT delimacorvinodaniela granulomatousresponsetoinvasivepulmonaryaspergillosisinanimmunotherapynaivehostamaladaptiveresponse AT garviaveronica granulomatousresponsetoinvasivepulmonaryaspergillosisinanimmunotherapynaivehostamaladaptiveresponse AT climacoantonette granulomatousresponsetoinvasivepulmonaryaspergillosisinanimmunotherapynaivehostamaladaptiveresponse |