1/1020. Allergic bronchopulmonary aspergillosis with obstruction of the upper respiratory tract. A case of allergic bronchopulmonary aspergillosis is presented. The only symptoms in this 24-year-old woman patient were those of recurrent nasal obstruction, including mucosal ulcerations, edema, and thick secretions within the nose. ( info) |
2/1020. An unusual presentation of paracoccidioidomycosis in an AIDS patient: a case report. A case of paracoccidioidomycosis presenting as a solitary pulmonary nodular lesion in a patient with acquired immunodeficiency syndrome (AIDS) is presented. This case illustrates that restricted lung lesions can also be found and diagnosed in immunodeficient patients. ( info) |
| A case of pulmonary sporotrichosis is described with secondary involvement of the rectum which was misdiagnosed as tuberculosis for a number of years. The authors suggest that every nondiagnosed chronic cavitary disease in the lung should include appropriate tests for sporotrichosis. ( info) |
4/1020. Disseminated penicillium marneffei infection presenting as a right upper lobe mass in an hiv positive patient. A 35 year old hiv positive patient from hong kong presented with a fever, cough and a skin rash in association with a lung mass, all of which were due to disseminated penicillium marneffei infection. He made a good response to antifungal therapy. The lung mass is a previously undescribed pulmonary manifestation of disseminated penicillium marneffei infection. Infections with this fungus should be suspected in any patient with hiv and respiratory symptoms who has visited southeast asia. ( info) |
| Six cases of pulmonary paracoccidioidomycosis diagnosed only by transthoracic fine needle aspiration are presented. The clinical and radiological presentation is varied. The most frequent use of this technique will permit the diagnosis of early lesions of mycosis. ( info) |
6/1020. Unusual pulmonary manifestations of disseminated penicillium marneffei infection in three AIDS patients. penicillium marneffei is a rare fungal pathogen which can cause human infections in people predominantly living in South-east asia and the southern portion of china. We report three cases of systemic P. marneffei infection in patients infected with hiv who lived in or had travelled to endemic areas. The clinical manifestation includes high fever, chills, weight loss, general malaise, chronic cough, haemoptysis, multiple skin lesions, abnormal liver function, etc. Chest X-ray showed single or multiple cavitary lesions with smooth or irregular thin wall. P. marneffei is cultured from blood, sputum, skin biopsy, sono-guide aspiration and bronchoscopic biopsy. After antifungal therapy with intravenous amphotericin b or oral fluconazole, skin lesions resolved completely within 2 weeks and cavitary lesions in the lungs changed to chronic fibrotic and interstitial processes after several months to a few years later. Our two cases had been treated as either pulmonary tuberculosis or suspected malignancy. A definite diagnosis and early treatment are important because this fungal infection is a marker of AIDS in South-east asia. ( info) |
7/1020. Pleural perforation of an aspergilloma cavity occurring in a patient with interstitial lung disease. An aspergilloma is a fungus ball resulting from colonization of pre-existing pulmonary cavities, which usually represents a non-invasive form of aspergillosis. Spontaneous rupture of the cavity containing the fungi into the pleural space is an unusual complication that has been reported occasionally in patients with leukemia and invasive aspergillosis. We report on this unusual complication occurring in a patient with underlying interstitial lung disease, in whom the aspergilloma cavity abruptly ruptured into the pleural space with subsequent hydropneumothorax and pleural spillage of the fungi. ( info) |
| blastomycosis is endemic in river valley areas of the southeastern and midwestern united states. Pulmonary manifestations include chronic cough and pleuritic pain. Radiographic appearance of the infection can mimic bronchogenic lung carcinoma. pleural effusion is rarely associated with this pulmonary infection, and empyema has not been previously reported. We report a case of pulmonary and pleural blastomyces dermatitidis infection presenting as empyema thoracis. diagnosis and treatment were attained with video-assisted thoracoscopic (VATS) pleural and lung biopsy and debridement. ( info) |
9/1020. The first imported case of pulmonary coccidioidomycosis in korea. Coccidioidomycosis is an endemic disease found in the southwestern part of North America. Travellers who visit the endemic area may carry the infection. We report a case of pulmonary coccidioidomycosis in a 74-year-old woman. She was healthy before visiting arizona, U.S.A twice. After returning home, she began to complain of intermittent dry coughing. The symptom was mild, however, and she was treated symptomatically. Later a chest radiograph, which was taken 4 years after the onset of the symptom, showed a solitary pulmonary nodule in the right upper lobe. By percutaneous needle aspiration, a few clusters of atypical cells were noted in the necrotic background. A right upper and middle lobectomy was done. A 1.5 x 1.5 x 1.2 cm sized tan nodule was present in otherwise normal lung parenchyma. Microscopically, the nodule consisted of aggregates of multiple solid granulomas inside of which was mostly necrotic. neutrophils and nuclear debris were scattered along the periphery of the necrotic foci. Numerous multinucleated giant cells were associated with the granulomas. In the necrotic area, mature spherules of coccidioides immitis, which were 30-100 microm in diameter, were present. They contained numerous endospores which ranged from 5 to 15 microm and were also noted in multinucleated giant cells. The diagnosis of coccidioidomycosis was made. She is doing well after the resection. ( info) |
10/1020. Pulmonary rhizopus rhizopodiformis cavitary abscess in a cardiac allograft recipient. Pulmonary mucormycosis is rare in solid organ transplant recipients. Only one case has been reported previously in a cardiac allograft recipient. However, the rhizopus species in that study was not identified. We report a case of successful surgical treatment of pulmonary cavitary mucormycosis due to rhizopus rhizopodiformis in a cardiac allograft transplant recipient. A review of the literature on pulmonary mucormycosis occurring in solid organ transplant recipients is also presented. ( info) |