Multiple fungus balls in a patient with chronic pulmonary aspergillosis

We present an atypical but very educational case of a 76 year ‐old man with interstitial lung disease diagnosed with chronic pulmonary aspergillosis who presented with multiple fungus balls in the right lower lobe. Key messageTypically, radiological examination in chronic pulmonary aspergillosis reveals cavities with fungus balls within the upper lobes. This case showed that multiple fungus balls can also be present in the lower lobes.
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Clinical Image Source Type: research

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CONCLUSION: The C/D ratio of tacrolimus was significantly correlated with the blood concentration of voriconazole when tacrolimus was intravenously administered. There was a difference in the mechanism of drug interaction between tacrolimus and voriconazole depending on the administration routes.
. PMID: 31426903 [PubMed - as supplied by publisher]
Source: International Journal of Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research
Cutaneous infections with Mycobacterium haemophilum are rare and usually characterized by tender, erythematous, ulcerating skin nodules. The risk of disease from nontuberculosis mycobacterium increases with progressive immunodeficiency. Here, we report a case of cutaneous mycobacterium infection in a patient on chronic immunosuppression for mixed connective tissue disease (MCTD)/interstitial lung disease (ILD). Our patient was receiving azathioprine, hydroxychloroquine sulfate (Plaquenil), and prednisone for MCTD, ILD, and rheumatoid arthritis.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
We present two cases of MDA5DM to illustrate some of its unique cutaneous features and review how patients ’ work-up should include autoantibodies and ferritin levels.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Authors: Matsuyama H, Miyoshi S, Sugino K, Ota H, Toyoda Y, Nihonyanagi Y, Shibuya K, Homma S Abstract Invasive pulmonary aspergillosis (IPA) usually occurs in patients with severe immunodeficiencies involving neutropenia. Underlying lung disease is a well-known risk factor of IPA; however, interstitial lung disease has not been recognized as a risk factor of IPA. We herein report a patient with fibrotic nonspecific interstitial pneumonia who experienced IPA without neutropenia. His IPA was fatal and showed unusually slow disease progression over one month. The computed tomography findings showed only nonspecific c...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
ABSTRACT The study of the human microbiome-and, more recently, that of the respiratory system-by means of sophisticated molecular biology techniques, has revealed the immense diversity of microbial colonization in humans, in human health, and in various diseases. Apparently, contrary to what has been believed, there can be nonpathogenic colonization of the lungs by microorganisms such as bacteria, fungi, and viruses. Although this physiological lung microbiome presents low colony density, it presents high diversity. However, some pathological conditions lead to a loss of that diversity, with increasing concentrations of so...
Source: Jornal Brasileiro de Pneumologia - Category: Respiratory Medicine Source Type: research
Abstract There has been an increase in fungal infections in patients with chronic lung disease over the past decades, which is associated with rapidly increasing costs to healthcare systems.An antifungal stewardship team was introduced to a tertiary cardiopulmonary hospital, consisting of a medical mycologist and pharmacy support providing weekly stewardship ward rounds, twice monthly multidisciplinary team meetings and a dedicated weekly outpatient clinic. A database was set up to record the activity of the stewardship team.During the first eighteen months of implementation the antifungal stewardship team had revie...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
This study was performed retrospectively with data collected over the years 2004 to 2013 at Shanghai Pulmonary Hospital, Tongji University, and included 77 patients whose lower respiratory tract (LRT) samples tested positive for. Our analysis considered blood examinations of CD3+, CD4+, CD8+, CD4+/CD8+, IgG, IgA and IgM levels. RESULTS: CD4+/CD8+ double positive cells, representing cell-mediated immunity, were less abundant in IPA patients with COPD than those with ILD and NCFB (0.81±0.09 vs. 1.39±0.25 and 0.81±0.09 vs. 1.57±0.06, respectively, P
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
We report a successful treatment with voriconazole (VRCZ) for chronic progressive pulmonary aspergillosis (CPPA) in a patient with dermatomyositis-associated interstitial lung disease (DM-ILD) treated with tacrolimus. A 73-year-old man with DM-ILD, treated with tacrolimus and prednisolone, complained of productive cough and his chest X-ray showed infiltration in the left upper lung field. We diagnosed CPPA and added VRCZ. Although we reduced the dose of tacrolimus for drug interaction, serum VRCZ level increased after the treatment. The patient was found to have cytochrome P450 (CYP) 2C19 *2/*2, a genetic polymorphism in p...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
CONCLUSIONS Through the present retrospective study, CPA seems to be a common sequel to lobectomy in lung cancer patients, and COPD and ILD represent strong risk factors of postoperative CPA. Because of the poor clinical outcome of lung cancer patients who develop CPA after lobectomy, careful follow-up using several examinations and chest radiographs to make CPA diagnosis may be essential.
Source: Interactive CardioVascular and Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Mediastinum, Pleura, Cardiac - pharmacology, Cardiac - physiology, Cardiac - other Thoracic Source Type: research
We report a female non-small cell lung cancer patient who developed ILD after a few days of crizotinib therapy. She showed a significant improvement after a high dose of pulse corticosteroid therapy, both radiologically and clinically. Unfortunately, the patient subsequently developed an aspergillosis superinfection leading to death. Our experience suggests that high-dose steroid therapy may be efficacious in the management of a severe complication of crizotinib therapy. However, potent antifungal therapy should be considered to prevent the risk of severe aspergillosis.Case Rep Oncol 2015;8:169-173
Source: Case Reports in Oncology - Category: Cancer & Oncology Source Type: research
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