Invasive Subacute Pulmonary Aspergillosis After Puerperal Sepsis: Case Report

Subacute invasive aspergillosis is an infection that locally destroys lung parenchyma, and it affects patients with mild immunocompromise. The diagnosis is made by clinical symptoms, imaging, and laboratory results related to the infection. Early diagnosis and treatment is imperative for a favorable...

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Published inJIM - high impact case reports Vol. 8; p. 2324709620977707
Main Authors Briones-Claudett, Killen H., Briones-Claudett, Mónica H., Murillo Vasconez, Roger Alexander, Alfonzo Pacheco, María F., Martinez Armijo, Eduardo Andres, Briones Zamora, Killen H., Briones Marquez, Diana C., Franco Chávez, Diana, Grunauer, Michelle
Format Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 2020
Sage Publications Ltd
SAGE Publishing
Subjects
Aspergillosis
Bronchoscopy
Case Report
Case reports
Fungal infections
Infections
Lavage
Sepsis
pneumonia
bronchoalveolar lavage
aspergillosis
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Summary:Subacute invasive aspergillosis is an infection that locally destroys lung parenchyma, and it affects patients with mild immunocompromise. The diagnosis is made by clinical symptoms, imaging, and laboratory results related to the infection. Early diagnosis and treatment is imperative for a favorable patient outcome. In this article, we present the case of a 19-year-old woman who was admitted to the intensive care unit for puerperal sepsis where a hysterectomy was performed. During her hospitalization, she presented atelectasis of the left lung and hemodynamic instability. Chest X-ray and chest computed tomography scan were performed and showed round opacities. It was decided to perform flexible bronchoscopy with bronchoalveolar lavage. An unusual subacute form of implementation of aspergillosis was confirmed by a bronchoalveolar lavage culture that showed the presence of Aspergillus. Images taken during bronchoscopy revealed Aspergillus implantation in the lung and serum galactomannan antigen test was positive. Voriconazole was introduced, 200 mg daily. The patient showed clinical improvement and was discharged from our hospital. We conclude that subacute invasive aspergillosis is a serious infection that can lead to high mortality. Bronchoscopy with bronchoalveolar lavage allows access and effective visualization of the airway as well as sampling for Aspergillus identification.
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ISSN:2324-7096
2324-7096
DOI:10.1177/2324709620977707