Airway obstruction and acute respiratory failure due to Aspergillus tracheobronchitis.
OBJECTIVE
To report a patient with lymphoma who developed Aspergillus tracheobronchitis resulting in airway obstruction and acute respiratory failure.


METHODS
Case report.


METHODS
Intensive care unit of a tertiary care hospital.


METHODS
A 22-yr-old female with lymphoma who developed a respiratory infection 3 months after completing immunosuppressive therapy. She was treated empirically with broad spectrum antibiotics and subsequently received a supplementary chemotherapeutic course. Soon afterward she developed severe respiratory failure. Chest radiograph showed atelectasis of the right upper and lower lobes.


METHODS
Emergent mechanical ventilation; fiberoptic bronchoscopy.


RESULTS
Fiberoptic bronchoscopy revealed extensive obstruction of both main and subsegmental bronchi with a solid mass strongly adhered to the bronchial wall; both histologic examination and culture of that mass revealed Aspergillus. The patient died of refractory hypoxemia a few days later.


CONCLUSIONS
Aspergillus tracheobronchitis should be considered in immunocompromised patients with suspected lung infection even when the main radiographic finding is atelectasis. Bronchoscopy and histologic examination of identified intraluminal material should be performed as soon as possible.
Routsi
Christina
C
Critical Care Department, Medical School of Athens University, Evangelismos Hospital, Athens, Greece.
Kaltsas
Panagiotis
P
Bessis
Evangelos
E
Rontogianni
Demetra
D
Kollias
Spyros
S
Roussos
Charis
C
D000208:Acute Disease; D000328:Adult; D000402:Airway Obstruction / Q000209:etiology; D001228:Aspergillosis / Q000150:complications*; D001991:Bronchitis / Q000150:complications* / Q000382:microbiology*; D005260:Female; D006801:Humans; D012131:Respiratory Insufficiency / Q000209:etiology*; D014136:Tracheitis / Q000150:complications* / Q000382:microbiology*