title: Acute Aspergillus pneumonia associated with mouldy tree bark-chippings, complicated by anti-glomerular basement membrane disease causing permanent renal failure.
abstract: A non-immunocompromised man developed acute Aspergillus pneumonia after spreading mouldy tree bark mulch. Despite normal renal function at presentation, he developed rapidly progressive glomerulonephritis with acute kidney injury due to anti-glomerular basement membrane antibodies (anti-GBM) 4 weeks later. He remained dialysis dependent and died of sepsis 10 months later. We hypothesise that he contracted invasive pulmonary Aspergillosis from heavy exposure to fungal spores, leading to epitope exposure in the alveoli with subsequent development of GBM auto-antibodies.
authors.affiliation: Manchester Academic Health Science Centre, University of Manchester, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Butler
authors.affiliation: Manchester Academic Health Science Centre, University of Manchester, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
authors.forename: Tomos
authors.initials: T
authors.lastname: Brockley
authors.affiliation: National Aspergillosis Centre, Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK.
authors.forename: David
authors.initials: D
authors.lastname: Denning
authors.affiliation: National Aspergillosis Centre, Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Richardson
authors.affiliation: Manchester Academic Health Science Centre, University of Manchester, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Chisholm
authors.affiliation: Manchester Academic Health Science Centre, University of Manchester, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
authors.forename: Smeeta
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Manchester Academic Health Science Centre, University of Manchester, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
authors.forename: Ronan
authors.initials: R
authors.lastname: O'Driscoll
keywords: Anti-glomerular basement membrane disease; Aspergillosis; Goodpasture's disease; Tree bark-chippings