Fatal Aspergillus myocarditis following short-term corticosteroid therapy for chronic obstructive pulmonary disease.
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.
Carrascosa Porras
Miguel
M
Section of Internal Medicine, Internal Medicine Service, Hospital of Laredo, Spain. mcarrascosap@nexo.es
Herreras Martínez
Rosa
R
Corral Mones
Juan
J
Ares Ares
Miguel
M
Zabaleta Murguiondo
Mikel
M
Rüchel
Reinhard
R
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*
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone