Invasive pulmonary aspergillosis presenting as thoracic mass causing obstruction of the superior and inferior vena cava in an immunocompetent patient: a diagnostic dilemma.
Invasive pulmonary aspergillosis (IPA) is a disease of immunocompromised patients, but its prevalence is increasing in immunocompetent persons. Patients usually present with non-specific symptoms, sometimes consistent with bronchopneumonia. We discuss the case of a 19-year-old boy who presented with constitutional respiratory symptoms along with signs of obstruction of the superior and inferior vena cava. A chest radiograph was suggestive of a thoracic mass raising suspicion of bronchogenic carcinoma/ benign mass, sarcoidosis and tuberculosis, but a diagnosis of invasive aspergillosis was established. The patient showed excellent clinico-radiological improvement with administration of voriconazole. Invasive pulmonary aspergillosis may also present with atypical findings and should be considered in differentials when investigating a case even if the patient does not have a risk factor.
Moti lal
Ml
Bunkar
Dr. Rajenda Prasad Takhar, Respiratory Medicine,, Medical College Campus, Kota,, Rajasthan 324010 India, T: +919784006021 F: 0744 2471157, drrajtakhar@gmail.com.
Rajendra Prasad
RP
Takhar
Savita
S
Arya
D000402:Airway Obstruction / Q000175:diagnosis / Q000382:microbiology*; D003937:Diagnosis, Differential; D006801:Humans; D007121:Immunocompetence; D055744:Invasive Pulmonary Aspergillosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D013896:Thoracic Diseases / Q000175:diagnosis / Q000382:microbiology*; D014652:Vascular Diseases / Q000175:diagnosis / Q000382:microbiology*; D014682:Vena Cava, Inferior / Q000382:microbiology; D014683:Vena Cava, Superior / Q000382:microbiology; D055815:Young Adult