title: Fatal Aspergillus myocarditis following short-term corticosteroid therapy for chronic obstructive pulmonary disease.
abstract: A 58-y-old man with chronic obstructive pulmonary disease (COPD) was admitted for treatment of an acute exacerbation of his illness. The patient's condition initially improved after therapy with oxygen, bronchodilators, antibiotic and methylprednisolone (40 mg every 8 h) was started. Soon afterwards, however, the patient's clinical status deteriorated and he died on the fifth hospital day. Post-mortem examination revealed unsuspected, isolated fungal myocarditis. The fungus was later identified as Aspergillus by indirect immunofluorescence. To our knowledge, this is the first case of fatal Aspergillus myocarditis related to short-term (< 1 week) steroid therapy in a COPD patient. We believe that this case provides further evidence to support the possibility of life-threatening infections in COPD patients who receive even a short course of corticosteroid treatment.
authors.affiliation: Section of Internal Medicine, Internal Medicine Service, Hospital of Laredo, Spain. mcarrascosap@nexo.es
authors.forename: Miguel
authors.initials: M
authors.lastname: Carrascosa Porras
authors.forename: Rosa
authors.initials: R
authors.lastname: Herreras Martínez
authors.forename: Juan
authors.initials: J
authors.lastname: Corral Mones
authors.forename: Miguel
authors.initials: M
authors.lastname: Ares Ares
authors.forename: Mikel
authors.initials: M
authors.lastname: Zabaleta Murguiondo
authors.forename: Reinhard
authors.initials: R
authors.lastname: Rüchel
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D001230:Aspergillus; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000382:microbiology; D009205:Myocarditis / Q000150:complications* / Q000382:microbiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone