Invasive aspergillosis diagnosed by fine-needle aspiration of the thyroid gland.
Invasive aspergillosis has been increasingly recognized as causing significant morbidity and mortality in immunocompromised patients but has never been diagnosed by fine-needle thyroid aspiration. A 24-year-old female with systemic lupus erythematosus presented with cough, shortness of breath, and fever of unknown origin unresponsive to broad-spectrum antibiotics. History and physical examination failed to indicate a source of infection. An 111In white blood cell scan showed thyroid localization. Physical examination revealed a multinodular goiter with a left dominant nodule. Fine-needle aspiration biopsy of a thyroid nodule revealed branching hyphae suggestive of Aspergillus sp. Despite immediate and aggressive treatment with amphotericin B and fluconazole, the patient died of overwhelming infection.
Torres
A M
AM
Department of Medicine, Endocrinology, Diabetes and Metabolism, SUNY Health Science Center at Syracuse, New York 13210, USA.
Agrawal
S
S
Peters
S
S
Khurana
K
K
Feiglin
D
D
Schroeder
E
E
Izquierdo
R
R
D000328:Adult; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D013961:Thyroid Gland / Q000473:pathology*