INVASIVE PULMONARY ASPERGILLOSIS: DIAGNOSTIC CHALLENGES IN A RAPIDLY FATAL CASE
A. Sima, A. Francisc, A. Stoica
Abstract: Introduction. Invasive pulmonary aspergillosis is a severe fungal infection with a rapidly progressive course and high mortality, particularly when early diagnosis is missed. In its atypical forms, aspergillosis may clinically and radiologically mimic lung cancer, leading to critical delays in both diagnosis and treatment.
Case Presentation. We report the case of a 47-year-old chronic smoker (25 pack-years), with no known occupational exposure, admitted for a 12 days history of acute respiratory symptoms including high-grade fever (up to 39.9°C), productive cough with muco-purulent sputum, chills, myalgia, and headache. Bronchial biopsies collected during bronchoscopy were initially interpreted as suggestive of poorly differentiated non-small cell lung carcinoma. The clinical evolution was rapidly unfavorable, with the patient dying three weeks after admission. The autopsy, performed at the family’s request, ruled out malignancy and confirmed a diagnosis of invasive pulmonary aspergillosis with extensive parenchymal necrosis. Histopathological findings were suggestive of an infection caused by Aspergillus niger.
Conclusion. This case highlights the potential for misdiagnosis of invasive pulmonary aspergillosis in its forms that mimic lung tumors, and underscores the critical value of autopsy in establishing the etiological diagnosis in rapidly fatal cases. Keywords: pulmonary consolidation, aspergillosis, Aspergillus niger, Calcium oxalate crystal deposition, brown deposits.
, with no known occupational exposure, admitted for a 12 days history of acute respiratory symptoms including high-grade fever (up to 39.9°C), productive cough with muco-purulent sputum, chills, myalgia, and headache. Bronchial biopsies collected during bronchoscopy were initially interpreted as suggestive of poorly differentiated non-small cell lung carcinoma. The clinical evolution was rapidly unfavorable, with the patient dying three weeks after admission. The autopsy, performed at the family’s request, ruled out malignancy and confirmed a diagnosis of invasive pulmonary aspergillosis with extensive parenchymal necrosis. Histopathological findings were suggestive of an infection caused by Aspergillus niger.
<br />Conclusion. This case highlights the potential for misdiagnosis of invasive pulmonary aspergillosis in its forms that mimic lung tumors, and underscores the critical value of autopsy in establishing the etiological diagnosis in rapidly fatal cases.&redirect_uri=http://rjlm.ro/index.php/arhiv/1041)