title: Dissemination of invasive aspergillosis: diagnostic and management dilemmas.
abstract: Invasive aspergillosis is a highly lethal opportunistic infection that poses a significant threat to immunocompromised patients. With studies suggesting that the incidence of this disease is increasing, and mortality rates remain high, early diagnosis and treatment are very important to improve patient survival. We present a case of a 63-year-old woman on an immunosuppression regimen with methylprednisolone and azathioprine for the treatment of autoimmune hepatitis, who presented with neurological and respiratory symptoms leading to a rapid clinical decline. A final diagnosis of disseminated invasive aspergillosis was made at autopsy. This case emphasises the importance in maintaining a high index of suspicion to ensure that the proper workup, diagnosis and treatment can be initiated earlier in the clinical presentation in an effort to decrease the extremely high mortality in these cases.
authors.affiliation: Medicine Department, New York Hospital Queens-Weill Cornell Affiliate, Flushing, New York, USA.
authors.forename: Roxana Elena
authors.initials: RE
authors.lastname: Lazarescu
authors.affiliation: Department of Medicine, New York Hospital Queens, Flushing, New York, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Vinelli
mesh_terms: D001344:Autopsy; D001379:Azathioprine / Q000009:adverse effects; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D008775:Methylprednisolone / Q000009:adverse effects; D008875:Middle Aged
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine; D008775:Methylprednisolone