title: When pulmonary nodules, epistaxis and renal lesion do not add up to Wegener's granulomatosis?
abstract: Wegener's granulomatosis usually presents with clinical features of systemic vasculitis affecting lung, upper respiratory tract, kidney and even a nervous system. Yet, invasive pulmonary aspergillosis is characterised by invasion of blood vessels in the lungs, but the infection often spreads to kidneys, skin and central nervous system. We report a case of a 46-year-old male patient with no prior medical history. Clinical presentation included epistaxis, hemoptysis, hematuria and proteinuria, along with pulmonary nodular infiltrates. Differential diagnosis included invasive aspergillosis and Wegener's granulomatosis, but the diagnosis was only confirmed after autopsy. Establishing diagnosis of invasive aspergillosis remains a challenge for clinicians in acute care setting.
authors.affiliation: High Dependency Unit, 2Radiology Department, 3Intensive Care Unit; Institute for Pulmonary Diseases of Vojvodina Sremska Kamenica.
authors.forename: Biljana
authors.initials: B
authors.lastname: Joveš Sević
authors.forename: Miloš
authors.initials: M
authors.lastname: Stojanović
authors.forename: Dušanka
authors.initials: D
authors.lastname: Obradović
authors.forename: Srđan
authors.initials: S
authors.lastname: Stefanović
authors.forename: Uroš
authors.initials: U
authors.lastname: Batranović
mesh_terms: D003937:Diagnosis, Differential; D004844:Epistaxis; D014890:Granulomatosis with Polyangiitis; D006801:Humans; D007668:Kidney; D008168:Lung