title: An unusual case of Aspergillus fibrosing mediastinitis.
abstract: Fibrosing mediastinitis due to Aspergillus is rare, particularly in the immunocompetent host. Fibrosing mediastinitis due to Aspergillus species in the immunocompetent patient can be indolent and may be treated with antifungal therapy rather than surgery. We present a 78-year-old nonsmoking, nondiabetic woman with chronic fibrosing mediastinitis due to Aspergillus. Multiple attempts at securing a tissue diagnosis were inconclusive. Ultimately, Aspergillus infection was diagnosed by a video-assisted thoracoscopic surgical biopsy. The patient was started on oral voriconazole, and she remains clinically stable with radiographic improvement. A prolonged, perhaps lifelong, course of antifungal therapy is planned.
authors.affiliation: Division of Thoracic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Wightman
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Kim
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Proia
authors.forename: L Penfield
authors.initials: LP
authors.lastname: Faber
authors.forename: Paolo
authors.initials: P
authors.lastname: Gattuso
authors.forename: William H
authors.initials: WH
authors.lastname: Warren
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Liptay
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D001231:Aspergillus flavus / Q000302:isolation & purification*; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005355:Fibrosis; D006801:Humans; D008480:Mediastinitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed
chemical_list: D000935:Antifungal Agents