Pseudallescheria boydii or Aspergillus fumigatus in a lady with an unresolving lung infiltrate, and a literature review.
A 53-year-old lady with blood-stained sputum and pleuritic pain had a lingular opacity on CXR which failed to resolve. A bronchial aspirate and transbronchial biopsy revealed features of bronchocentric granulomatosis with dichotomous branching hyphae suggestive of Aspergillus infection. However, subsequent fungal culture grew Pseudallescheria boydii. This case demonstrates the similarity of clinical and histological features caused by these two fungi. This appears to be the first reported case of pulmonary pseudallescheria with a bronchocentric granulomatous response.
Lam
Sin-Man
SM
Division of Respiratory and Critical Care Medicine, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China. gsmlam@gmail.com
Lau
Arthur Chun-Wing
AC
Ma
Ming-Wai
MW
Yam
Loretta Yin-Chun
LY
D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D001232:Aspergillus fumigatus / Q000302:isolation & purification* / Q000472:pathogenicity; D005260:Female; D006801:Humans; D008168:Lung / Q000382:microbiology* / Q000473:pathology; D008875:Middle Aged; D008271:Mycetoma / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D011541:Pseudallescheria / Q000302:isolation & purification* / Q000472:pathogenicity