An unusual case of Aspergillus fibrosing mediastinitis.
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.
Wightman
Sean C
SC
Division of Thoracic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
Kim
Anthony W
AW
Proia
Laurie A
LA
Faber
L Penfield
LP
Gattuso
Paolo
P
Warren
William H
WH
Liptay
Michael J
MJ
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
D000935:Antifungal Agents