Pseudomembranous tracheobronchitis caused by Aspergillus in a patient after peripheral blood stem cell transplantation.
BACKGROUND
We report a case of pseudomembranous tracheobronchitis caused by Aspergillus fumigatus 2 years after matched unrelated stem cell transplant.


METHODS
The patient presented with dyspnoea and obstructive airway disease coinciding with the onset of chronic graft-versus-host disease (GVHD). Following treatment with higher immunosuppressive therapy for presumptive diagnosis of bronchiolitis obliterans, he subsequently developed recurrent spontaneous pneumomediastinum and progressive respiratory failure.


RESULTS
Tracheobronchial biopsy and culture of bronchoalveolar lavage (BAL) fluid revealed Aspergillus tracheobronchitis. Despite mechanical ventilation and antifungal therapy, he succumbed to progressive respiratory failure.


CONCLUSIONS
Aspergillus tracheobronchitis should be suspected in heavily immunosuppressed stem cell transplant recipients presenting with recurrent pneumomediastinum and progressive respiratory failure.
Koh
L P
LP
Department of Haematology, Singapore General Hospital, Singapore.
Goh
Y T
YT
Linn
Y C
YC
Hwang
J
J
Tan
P
P
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001232:Aspergillus fumigatus; D001706:Biopsy; D001991:Bronchitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D017809:Fatal Outcome; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D012121:Respiration, Artificial; D014136:Tracheitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D000935:Antifungal Agents