Microgranulomatous aspergillosis after shoveling wood chips: report of a fatal outcome in a patient with chronic granulomatous disease

• Published in: American journal of industrial medicine Vol. 22; no. 3; p. 411
• Main Authors: Conrad, D J, Warnock, M, Blanc, P, Cowan, M, Golden, J A
• Format: Journal Article
• Language: English
• Published: United States 1992
• Subjects: Adult; Aspergillosis - diagnostic imaging; Aspergillosis - etiology; Aspergillosis - pathology; Autopsy; Granulomatous Disease, Chronic - complications; Humans; Lung - pathology; Lung Diseases, Fungal - diagnostic imaging; Lung Diseases, Fungal - etiology; Lung Diseases, Fungal - pathology; Male; Occupational Diseases - diagnostic imaging; Occupational Diseases - etiology; Occupational Diseases - pathology; Radiography; Time Factors; Wood
• ISSN: 0271-3586
• DOI: 10.1002/ajim.4700220313

Chronic granulomatous disease is characterized by recurrent infections that result from an inability of phagocytes to kill organisms effectively. We describe a patient with this disease who developed aspergillus pneumonia after shoveling moldy cedar wood chips. Despite aggressive therapy, the patient's condition deteriorated and he died. At autopsy, the lungs revealed diffuse granulomas, all of the same age, with aspergillus organisms confined to the granulomas. We propose the term "microgranulomatous aspergillosis" for this response, which does not conform to the commonly described aspergillus syndromes. We conclude that susceptible immunosuppressed patients should be advised to avoid occupational situations where high spore concentrations are generated.