Airway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case report
Abstract Introduction Invasive pulmonary aspergillosis (IPA) is typically associated with immunocompromised patients, but rare occurrences have been documented in immunocompetent individuals. This presents diagnostic and therapeutic challenges due to atypical presentations and less apparent risk fac...
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2025-03-01
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| Online Access: | https://doi.org/10.1186/s12879-025-10694-z |
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| author | Imad Majeed Sundal Aziz Zaraq Rashid khan Forest Arnold |
| author_facet | Imad Majeed Sundal Aziz Zaraq Rashid khan Forest Arnold |
| author_sort | Imad Majeed |
| collection | DOAJ |
| description | Abstract Introduction Invasive pulmonary aspergillosis (IPA) is typically associated with immunocompromised patients, but rare occurrences have been documented in immunocompetent individuals. This presents diagnostic and therapeutic challenges due to atypical presentations and less apparent risk factors. Case presentation A 67-year-old Cambodian American female with a history of stable pulmonary nodules and a left neck schwannoma presented with a two-week history of cough and hemoptysis. Imaging revealed a left lower lobe lung mass suspicious for malignancy. Biopsy and bronchoalveolar lavage confirmed the diagnosis of invasive pulmonary aspergillosis, despite the patient’s lack of traditional immunosuppressive risk factors. Her environmental exposures, including a recent trip to Cambodia and a history of gardening, were likely contributing factors. The diagnosis of IPA in this immunocompetent patient was established through a combination of clinical presentation, radiographic findings, and microbiological evidence. Bronchoalveolar lavage and galactomannan testing were crucial in identifying the presence of Aspergillus. Histopathological examination of the biopsy specimen revealed the presence of Aspergillus fruiting bodies, an uncommon finding indicative of invasive disease. The patient was promptly started on voriconazole, the first-line antifungal agent for IPA, which led to an improvement in her symptoms. Moreover, her left neck mass schwannoma in the thyroid bed was also a rare entity. Conclusion This case highlights the importance of considering IPA as a differential diagnosis in immunocompetent individuals with relevant environmental exposures and preexisting lung conditions, even in the absence of classic immunosuppressive risk factors. |
| format | Article |
| id | doaj-art-8fd8966697c544fda1cc0e24327bce1d |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| spelling | doaj-art-8fd8966697c544fda1cc0e24327bce1d2025-08-20T03:01:41ZengBMCBMC Infectious Diseases1471-23342025-03-012511810.1186/s12879-025-10694-zAirway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case reportImad Majeed0Sundal Aziz1Zaraq Rashid khan2Forest Arnold3Department of Infectious diseases, University of Louisville HospitalDepartment of cardiology, Northwest general HospitalDepartment of Infectious diseases, University of Louisville HospitalDepartment of Infectious diseases, University of Louisville HospitalAbstract Introduction Invasive pulmonary aspergillosis (IPA) is typically associated with immunocompromised patients, but rare occurrences have been documented in immunocompetent individuals. This presents diagnostic and therapeutic challenges due to atypical presentations and less apparent risk factors. Case presentation A 67-year-old Cambodian American female with a history of stable pulmonary nodules and a left neck schwannoma presented with a two-week history of cough and hemoptysis. Imaging revealed a left lower lobe lung mass suspicious for malignancy. Biopsy and bronchoalveolar lavage confirmed the diagnosis of invasive pulmonary aspergillosis, despite the patient’s lack of traditional immunosuppressive risk factors. Her environmental exposures, including a recent trip to Cambodia and a history of gardening, were likely contributing factors. The diagnosis of IPA in this immunocompetent patient was established through a combination of clinical presentation, radiographic findings, and microbiological evidence. Bronchoalveolar lavage and galactomannan testing were crucial in identifying the presence of Aspergillus. Histopathological examination of the biopsy specimen revealed the presence of Aspergillus fruiting bodies, an uncommon finding indicative of invasive disease. The patient was promptly started on voriconazole, the first-line antifungal agent for IPA, which led to an improvement in her symptoms. Moreover, her left neck mass schwannoma in the thyroid bed was also a rare entity. Conclusion This case highlights the importance of considering IPA as a differential diagnosis in immunocompetent individuals with relevant environmental exposures and preexisting lung conditions, even in the absence of classic immunosuppressive risk factors.https://doi.org/10.1186/s12879-025-10694-zAspergillosisImmunocompetent patientsThyroid SchwannomaFruiting bodies |
| spellingShingle | Imad Majeed Sundal Aziz Zaraq Rashid khan Forest Arnold Airway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case report BMC Infectious Diseases Aspergillosis Immunocompetent patients Thyroid Schwannoma Fruiting bodies |
| title | Airway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case report |
| title_full | Airway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case report |
| title_fullStr | Airway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case report |
| title_full_unstemmed | Airway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case report |
| title_short | Airway-centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland Schwannoma: a case report |
| title_sort | airway centered invasive pulmonary aspergillosis featuring histopathologic fruiting bodies in an immunocompetent patient with a rare incidental finding of thyroid gland schwannoma a case report |
| topic | Aspergillosis Immunocompetent patients Thyroid Schwannoma Fruiting bodies |
| url | https://doi.org/10.1186/s12879-025-10694-z |
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