Invasive subglottal aspergillosis in a patient with severe aplastic anemia: a case report.
A 19-year-old female with aplastic anemia who developed subglottal aspergillosis is reported. She presented with fever, cough and stridor. Inspiratory dyspnea progressed rapidly and emergent tracheostomy was performed, which confirmed the diagnosis. In spite of intensive anti-fungal treatment combined with adoptive immunotherapy, Aspergillus infection expanded and she died of pulmonary aspergillosis. Autopsy revealed the fungal mass obstructing the trachea and disseminated pulmonary aspergillosis. Difficulties in diagnosis and management of subglottal Aspergillus infection are discussed.
Nagasawa
M
M
Department of Pediatrics, Tokyo, Japan. mnagasawa.ped@tmc.ac.jp
Itoh
S
S
Tomizawa
D
D
Kajiwara
M
M
Sugimoto
T
T
Kumagai
J
J
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000741:Anemia, Aplastic / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D017809:Fatal Outcome; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007830:Larynx / Q000382:microbiology / Q000473:pathology; D008775:Methylprednisolone / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole; D008775:Methylprednisolone