title: A Fortuitous Turn of Evidence in an Elderly Female - A Case of Pulmonary Fusariosis.
abstract: Pulmonary mycosis is seen infrequently in our country. It is more common in the immunocompromised. The infections caused by less known species likeFusariumhave been found to be increasing in incidence in other parts of the world. We hereby report its occurrence in a 79-year-old, non-immunocompromised female who presented with pyrexia of unknown origin. Her Alanine Phosphatase (ALP) and Lactate Dehydrogenase (LHD) levels were raised. CT scan showed interstitial thickening in subpleural aspect of lungs and multiple enlarged lymph nodes in mediastinum. Liver showed multiple hypodense lesions. Metastasis was suspected for which Fine Needle Aspiration Cytology (FNAC) of liver was done which showed foci of regenerative hepatocytes with desmoplastic stromal tissue fragments and negative for tumour. Her Alpha Fetoprotein (AFP) was normal. The bronchial tree cytology showed endobronchial cells, dust-laden macrophages and chronic inflammatory cells along with fungi on Pap smear studies. This was confirmed by culture that grewFusariumspecies.after one week of incubation. The acutely branching septate hyphae ofFusariumspecies are identical to those ofAspergillus species.In a patient who has a disseminated infection with a septate fungus, growth in culture is important to identify the specific organism and subsequently treatment with appropriate antifungals. In cases like ours, where the infection simulates malignancy, it is even more important to make the correct diagnosis to give the appropriate treatment.
authors.affiliation: Assistant Professor, Department of Pathology, Manipal University , Mangaluru, Karnataka, India .
authors.forename: Saraswathy
authors.initials: S
authors.lastname: Sreeram
authors.affiliation: Professor, Department of Pathology, Manipal University , Mangaluru, Karnataka, India .
authors.forename: Flora Dorothy
authors.initials: FD
authors.lastname: Lobo
authors.affiliation: Professor and Head of the Department, Department of Pulmonary Medicine, Manipal University , Mangaluru, Karnataka, India .
authors.forename: Vishak
authors.initials: V
authors.lastname: Acharya
authors.affiliation: Associate Professor, Department of Microbiology, Manipal University , Mangaluru, Karnataka, India .
authors.forename: Vishwas
authors.initials: V
authors.lastname: Saralaya
keywords: Cytology; Filamentous fungi; Fusarium; Immunocompetent; Lung cancer