title: Invasive aspergillosis diagnosed by fine-needle aspiration of the thyroid gland.
abstract: 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.
authors.affiliation: Department of Medicine, Endocrinology, Diabetes and Metabolism, SUNY Health Science Center at Syracuse, New York 13210, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Torres
authors.forename: S
authors.initials: S
authors.lastname: Agrawal
authors.forename: S
authors.initials: S
authors.lastname: Peters
authors.forename: K
authors.initials: K
authors.lastname: Khurana
authors.forename: D
authors.initials: D
authors.lastname: Feiglin
authors.forename: E
authors.initials: E
authors.lastname: Schroeder
authors.forename: R
authors.initials: R
authors.lastname: Izquierdo
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D013961:Thyroid Gland / Q000473:pathology*