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Jayaram S, Gustafson BR, Paul GR. Bilateral bronchomediastinal fistulae in a child-A double surprise! Pediatr Pulmonol 2024; 59:2036-2040. [PMID: 38578140 DOI: 10.1002/ppul.27004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Swati Jayaram
- Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, Ohio, Columbus, USA
| | - Brooke R Gustafson
- Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, Ohio, Columbus, USA
| | - Grace R Paul
- Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, Ohio, Columbus, USA
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2
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Khatun M, Julson J, Taylor DW, Foxworthy BO, Beierle EA, Aye JM. Invasive pulmonary aspergillosis presenting with tracheopleural fistula in a pediatric patient with a history of rhabdomyosarcoma. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2023; 92. [DOI: 10.1016/j.epsc.2023.102602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023] Open
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3
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Deng W, Jiang Y, Qin J, Chen G, Lv Y, Lei Y, Luo J, Hong K, Huang B, Qin L, Tang X, Ye L, Dang Y, Wang C, Long F, Wang K, Kong J. Metagenomic Next-Generation Sequencing Assists in the Diagnosis of Mediastinal Aspergillus fumigatus Abscess in an Immunocompetent Patient: A Case Report and Literature Review. Infect Drug Resist 2023; 16:1865-1874. [PMID: 37020798 PMCID: PMC10069495 DOI: 10.2147/idr.s399484] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
Background Aspergillus fumigatus is an opportunistic fungal pathogen, which is commonly found in lungs and rarely causes infections in mediastinum. Mediastinal Aspergillus abscess is a serious infectious condition, and is characterized by difficult diagnosis due to its clinical manifestations being nonspecific. Case Presentation Here, we report a case of a mediastinal Aspergillus fumigatus abscess in an immunocompetent patient. The patient was a 45-year-old woman who presented with a 20-day history of sore throat without any underlying diseases. Chest computed tomography (CT) showed a mass in the anterior superior mediastinum. Metagenomic next-generation sequencing (mNGS) identified Aspergillus fumigatus sequences in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) tissue, indicating the mediastinal Aspergillus fumigatus infection of this patient. The following mediastinal biopsy histological analysis and tissue fungi culture also suggested Aspergillus fumigatus infection, confirming the mNGS detection. The patient was diagnosed with mediastinal aspergillosis caused by Aspergillus fumigatus. After timely voriconazole treatment, the patient was discharged with good condition. Conclusion Our study presented a rare case with mediastinal Aspergillus fumigatus abscess in an immunocompetent patient. As a new clinical diagnostic method, mNGS could assist timely diagnosis and precise treatment of Aspergillus infection.
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Affiliation(s)
- Wusheng Deng
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yun Jiang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Shaoyang University, Shaoyang, Hunan, People’s Republic of China
| | - Jiaoxia Qin
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yongjie Lv
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yanmei Lei
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jing Luo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Kangkang Hong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Bing Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Luhai Qin
- Department of Pulmonology, Hechi Traditional Chinese Medicine Hospital, Hechi, Guangxi, People’s Republic of China
| | - Xiujia Tang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Liumei Ye
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yuhai Dang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Chao Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Feiyang Long
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jinliang Kong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
- Correspondence: Jinliang Kong; Ke Wang, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, 530021, People’s Republic of China, Email ;
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Muacevic A, Adler JR, Agarwal R. An Unusual Pulmonary Aspergillus Infection: Endobronchial Aspergilloma. Cureus 2023; 15:e33587. [PMID: 36788918 PMCID: PMC9910822 DOI: 10.7759/cureus.33587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 01/11/2023] Open
Abstract
Endobronchial aspergilloma (EBA) is an extremely rare presentation of pulmonary involvement of Aspergillus. It is a noninvasive form of pulmonary aspergillosis where the fungus overgrows and colonizes the bronchial lumen. The patient may present with chronic cough, dyspnea, hemoptysis, or wheezing. The diagnosis is usually incidental when bronchoscopy is performed to evaluate the cause of hemoptysis or radiological abnormalities. Here, we report a case of a middle-aged female who presented with hemoptysis and right middle lobe collapse and was subsequently diagnosed to have EBA on bronchoscopy with endobronchial biopsy. Although EBA is rare, it should be considered as a differential in the evaluation of endobronchial mass lesions.
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5
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Porzionato A, Stocco E, Emmi A, Macchi V, De Caro R. Case Report: Sudden Fatal Hemorrhage in Ulcerative Fungal Laryngotracheitis-A Pediatric Case Report. Front Pediatr 2021; 9:764027. [PMID: 35087772 PMCID: PMC8787292 DOI: 10.3389/fped.2021.764027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022] Open
Abstract
In this report, we describe an autopsy case of a child affected by acute lymphoblastic leukemia and opportunistic pulmonary aspergillosis. The patient died because of a full-thickness tracheal wall ulceration with right inferior thyroid artery lesion and sudden hemorrhage, likely ascribable to undiagnosed invasive Aspergillus laryngotracheitis. Aspergillus infection, particularly in immunocompromised patients, should be considered an urgent risk factor to manage as it may lead to sudden fatal events in absence of evident critical symptoms.
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Affiliation(s)
- Andrea Porzionato
- Section of Human Anatomy, Department of Neuroscience, University of Padova, Padova, Italy
| | - Elena Stocco
- Section of Human Anatomy, Department of Neuroscience, University of Padova, Padova, Italy
| | - Aron Emmi
- Section of Human Anatomy, Department of Neuroscience, University of Padova, Padova, Italy
| | - Veronica Macchi
- Section of Human Anatomy, Department of Neuroscience, University of Padova, Padova, Italy
| | - Raffaele De Caro
- Section of Human Anatomy, Department of Neuroscience, University of Padova, Padova, Italy
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6
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Acute Post-Influenza Aspergillosis with Central Airway Obstruction Mimicking Asthma. Am J Med Sci 2020; 361:e27-e28. [PMID: 32958163 DOI: 10.1016/j.amjms.2020.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/01/2020] [Accepted: 08/08/2020] [Indexed: 11/20/2022]
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7
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Pastore Junior L, Moura RABD, Rotheia Júnior RR. Endobronchial aspergilloma. J Bras Pneumol 2020; 46:e20190279. [PMID: 32130335 PMCID: PMC7462692 DOI: 10.36416/1806-3756/e20190279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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8
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Ngu S, Narula N, Abureesh M, Li JJ, Chalhoub M. Endobronchial aspergilloma-a comprehensive literature review with focus on diagnosis and treatment modalities. Eur J Clin Microbiol Infect Dis 2019; 39:601-605. [PMID: 31741102 DOI: 10.1007/s10096-019-03726-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/26/2019] [Indexed: 11/28/2022]
Abstract
Endobronchial aspergilloma (EBA) is a rare manifestation of pulmonary infection with Aspergillus spp. Comprised of hyphae, mucus, and cellular debris, the massive fungus overgrowth can lead to obstructive pneumonitis in large airways, manifesting as cough, dyspnea, hemoptysis, or weight loss. The aim of this paper is to review the literature on endobronchial aspergilloma to further elucidate this disease entity and to classify it as a non-invasive form of pulmonary aspergillosis. A descriptive analysis was performed on articles on PubMed database that contained the key word "endobronchial aspergilloma." A total of 28 cases were obtained. Four articles were excluded as they were not available in the English format. Although EBA is extremely rare, it should be considered in the differential diagnosis of endobronchial masses in immunocompromised patients. There is a potential for the disease entity to progress to tracheobronchitis and fulminant respiratory failure. As such, early detection with bronchoscopy, biopsy, and culture is required to confirm pulmonary aspergillosis. Current treatment regimens remain to be optimized, though piecemeal resection of the mycetoma with bronchoscopic techniques with the addition of systemic antifungals and their combinations has been reported as efficacious.
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Affiliation(s)
- Sam Ngu
- Staten Island University Hospital, 70 Hancock Street, Unit 1C, Staten Island, NY, 10305, USA.
| | - Naureen Narula
- Staten Island University Hospital, 70 Hancock Street, Unit 1C, Staten Island, NY, 10305, USA
| | - Mohammad Abureesh
- Staten Island University Hospital, 70 Hancock Street, Unit 1C, Staten Island, NY, 10305, USA
| | - Jia Jian Li
- Staten Island University Hospital, 70 Hancock Street, Unit 1C, Staten Island, NY, 10305, USA
| | - Michel Chalhoub
- Staten Island University Hospital, 70 Hancock Street, Unit 1C, Staten Island, NY, 10305, USA
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9
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Lugg ST, Grudzinska F, Kalkat MS, Sutton B. A rare case of spontaneous tracheal perforation. BMJ Case Rep 2017; 2017:bcr-2017-220731. [PMID: 28720603 DOI: 10.1136/bcr-2017-220731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sebastian Thomas Lugg
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Inflammation and Ageing, Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| | - Frances Grudzinska
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Inflammation and Ageing, Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| | - Maninder Singh Kalkat
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Benjamin Sutton
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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10
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Keshishyan S, DeLorenzo L, Hammoud K, Avagyan A, Assallum H, Harris K. Infections causing central airway obstruction: role of bronchoscopy in diagnosis and management. J Thorac Dis 2017; 9:1707-1724. [PMID: 28740687 DOI: 10.21037/jtd.2017.06.31] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Central airway obstructive infections (CAOI) are challenging medical conditions that may represent an advanced and complicated process of ongoing infections. The epidemiology of CAOI is unknown as well as the pathophysiology and the mechanism of development. This is due to sparse data in the literature that consists mainly of case reports and retrospective case series. CAOI can be caused by fungal, bacterial, parasitic and viral infections. Most patients with CAOI can be diagnosed clinically and with chest imaging, which demonstrate obstruction of the central airways. However, bronchoscopy is commonly used to confirm and obtain a specific diagnosis to guide specific therapy. In recent years, interventional pulmonology (IP) is becoming widely available and offer a minimally invasive approach for the management of central airway diseases such as cancers, benign strictures, and other conditions. Various bronchoscopic modalities are used to treat central airway obstruction (CAO), such as mechanical debulking, endobronchial laser therapy, electrocautery, argon plasma coagulation, cryotherapy, and airway stenting. In patients with CAOI, the role of therapeutic bronchoscopy is not clearly defined, but many isolated reports in the literature described bronchoscopic intervention in combination with medical therapy as the initial management approach. In this paper, we present cases of CAOI that underwent bronchoscopic intervention as part of their management. We described the infectious etiology, locations, bronchoscopic findings and bronchoscopic modalities for airway management.
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Affiliation(s)
- Sevak Keshishyan
- Division of Pulmonary and Critical Care, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
| | - Lawrence DeLorenzo
- Division of Pulmonary and Critical Care, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
| | - Kassem Hammoud
- Department of Infectious Diseases, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Arpine Avagyan
- Division of Internal Medicine, Department of Medicine, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Hussein Assallum
- Division of Pulmonary and Critical Care, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
| | - Kassem Harris
- Section of Interventional Pulmonology, Division of Pulmonary Critical Care and Sleep, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
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11
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Dhillon SS, Saoud M, Harris K. Complex multimodality central airway management of aspergillus pseudomembranous tracheobronchitis. J Thorac Dis 2017; 9:915-919. [PMID: 28523137 DOI: 10.21037/jtd.2017.03.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted in clinical improvement and allowed time for antifungal therapy to take effect. To the best of our knowledge, the use of a peripheral Y stent has never been described in the setting of PTB.
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Affiliation(s)
- Samjot Singh Dhillon
- Department of Medicine, Pulmonary Medicine/Interventional Pulmonary Section, Roswell Park Cancer Institute, Buffalo, NY, USA.,Department of Pulmonary, Critical and Sleep Medicine, State University of New York (SUNY), Buffalo, NY, USA
| | - Marwan Saoud
- Department of Medicine, State University of New York (SUNY), Buffalo, NY, USA
| | - Kassem Harris
- Department of Pulmonary, Critical Care and Sleep Medicine, Interventional Pulmonology Section, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
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12
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Araújo D, Figueiredo M, Monteiro P. Endobronchial aspergilloma: An unusual presentation of pulmonary aspergillosis. REVISTA PORTUGUESA DE PNEUMOLOGIA 2015; 22:61-2. [PMID: 26299769 DOI: 10.1016/j.rppnen.2015.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 06/29/2015] [Accepted: 07/01/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- D Araújo
- Respiratory Department, CHAA, Guimarães, Portugal.
| | - M Figueiredo
- Respiratory Department, CHAA, Guimarães, Portugal
| | - P Monteiro
- Anatomy Department, CHAA, Guimarães, Portugal
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