title: Airway obstruction and acute respiratory failure due to Aspergillus tracheobronchitis.
abstract: 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.
authors.affiliation: Critical Care Department, Medical School of Athens University, Evangelismos Hospital, Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Routsi
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kaltsas
authors.forename: Evangelos
authors.initials: E
authors.lastname: Bessis
authors.forename: Demetra
authors.initials: D
authors.lastname: Rontogianni
authors.forename: Spyros
authors.initials: S
authors.lastname: Kollias
authors.forename: Charis
authors.initials: C
authors.lastname: Roussos
mesh_terms: 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*