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Unusual form of endobronchial aspergillosis in a patient with cystic fibrosis
Author(s) -
Sammut Paul H.,
Howard Susan T.,
Linder James,
Colombo John L.
Publication year - 1993
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950160114
Subject(s) - medicine , aspergillosis , cystic fibrosis , aspergillus fumigatus , allergic bronchopulmonary aspergillosis , bronchoscopy , bronchoalveolar lavage , sputum , bronchus , mycosis , asymptomatic , respiratory disease , sputum culture , surgery , gastroenterology , lung , pathology , immunology , tuberculosis , immunoglobulin e , antibody
The isolation of Aspergillus fumigatus from airway secretions from patients with cystic fibrosis (CF) is common and usually denotes asymptomatic colonization or allergic broncho‐pulmonary aspergillosis (ABPA). A 12‐year‐old boy with CF acutely developed moderately severe symptoms of unremitting cough, fever, dyspnea, weight loss, and cyanosis. Chest radiographs demonstrated widespread unilateral infiltrates and volume loss. By bronchoscopy tenacious mucous plugs were seen occluding the left lower lobe bronchus. Cultures from sputum and sequential bronchoalveolar lavage grew Aspergillus fumigatus , but other significant criteria for diagnosing APBA were lacking. No improvement was seen with a 3 week course of systemic corticosteroid and antibiotic therapy. Treatment with amphotericin B and short‐term mechanical ventilation resulted in rapid resolution of all symptoms. This form of endobronchial aspergillosis has not been described previously. Pediatr Pulmonol. 1993; 16:69–73. © 1993 Wiley‐Liss, Inc.