Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature

Aspergilloma (a saprophytic infection) typically colonizes lung cavities due to underlying diseases such as tuberculosis, bronchiectasis, cavitary lung cancer, sarcoidosis, and pulmonary infarctions. Rarely, aspergilloma has been noted within a hydatid cyst. Even if this was the case, it is more com...

Full description

Saved in:
Bibliographic Details
Main Authors: Aayush Adhikari, Surendra Khanal, Sagar Rana Magar, Srijana Thapa, Srijana Khati, Rajan Lamichhane, Kundan Marasini
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2023/6975041
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849400009734225920
author Aayush Adhikari
Surendra Khanal
Sagar Rana Magar
Srijana Thapa
Srijana Khati
Rajan Lamichhane
Kundan Marasini
author_facet Aayush Adhikari
Surendra Khanal
Sagar Rana Magar
Srijana Thapa
Srijana Khati
Rajan Lamichhane
Kundan Marasini
author_sort Aayush Adhikari
collection DOAJ
description Aspergilloma (a saprophytic infection) typically colonizes lung cavities due to underlying diseases such as tuberculosis, bronchiectasis, cavitary lung cancer, sarcoidosis, and pulmonary infarctions. Rarely, aspergilloma has been noted within a hydatid cyst. Even if this was the case, it is more common to find the coexistence of aspergilloma and pulmonary echinococcal cysts in immunocompromised individuals. It is, however, very uncommon to find this coinfection in normal immune status individuals. Here, we report on the successfully treated case of a 30-year-old immunocompetent female from Western Nepal with histologically proven coinfection by these two pathogens. She had a prolonged history of exposure to domesticated dogs. She suffered from hemoptysis from time to time for 3 years with increased frequency in the last 30 days. She was misdiagnosed clinically during a past medical visit at a local health center. Her computed tomography (CT) scans showed well-defined nonenhancing cystic lesions in the anterior basal segment of the right lower lobe adjacent to the major fissure. She underwent enucleation of the cyst via right posterolateral thoracotomy. On further histopathological evaluation, laminated membranes of the ectocyst along with fungal elements were found, and periodic acid-Schiff (PAS) staining revealed Aspergillus in the form of septate hyphae and acute angle branching. Owing to patient’s economic constraints and unavailability in our center, DNA testing and molecular characterization could not be performed which further highlights the essence of diagnosing and managing such cases in resource poor settings. Eventually, we reviewed 12 confirmed cases of this coinfection in immunocompetent individuals during a period of 7 years (2015–2022) comparing them to a systematic review of 22 confirmed cases of the same coinfection from 1995 to 2014.
format Article
id doaj-art-a4c6fae516304d469b6bc94657aef417
institution Kabale University
issn 2090-6633
language English
publishDate 2023-01-01
publisher Wiley
record_format Article
series Case Reports in Infectious Diseases
spelling doaj-art-a4c6fae516304d469b6bc94657aef4172025-08-20T03:38:12ZengWileyCase Reports in Infectious Diseases2090-66332023-01-01202310.1155/2023/6975041Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of LiteratureAayush Adhikari0Surendra Khanal1Sagar Rana Magar2Srijana Thapa3Srijana Khati4Rajan Lamichhane5Kundan Marasini6Manang District HospitalDepartment of Internal MedicineMaharajgunj Medical CampusManmohan Cardiothoracic Vascular and Transplant CenterDepartment of PathologyMaharajgunj Medical CampusDepartment of RadiologyAspergilloma (a saprophytic infection) typically colonizes lung cavities due to underlying diseases such as tuberculosis, bronchiectasis, cavitary lung cancer, sarcoidosis, and pulmonary infarctions. Rarely, aspergilloma has been noted within a hydatid cyst. Even if this was the case, it is more common to find the coexistence of aspergilloma and pulmonary echinococcal cysts in immunocompromised individuals. It is, however, very uncommon to find this coinfection in normal immune status individuals. Here, we report on the successfully treated case of a 30-year-old immunocompetent female from Western Nepal with histologically proven coinfection by these two pathogens. She had a prolonged history of exposure to domesticated dogs. She suffered from hemoptysis from time to time for 3 years with increased frequency in the last 30 days. She was misdiagnosed clinically during a past medical visit at a local health center. Her computed tomography (CT) scans showed well-defined nonenhancing cystic lesions in the anterior basal segment of the right lower lobe adjacent to the major fissure. She underwent enucleation of the cyst via right posterolateral thoracotomy. On further histopathological evaluation, laminated membranes of the ectocyst along with fungal elements were found, and periodic acid-Schiff (PAS) staining revealed Aspergillus in the form of septate hyphae and acute angle branching. Owing to patient’s economic constraints and unavailability in our center, DNA testing and molecular characterization could not be performed which further highlights the essence of diagnosing and managing such cases in resource poor settings. Eventually, we reviewed 12 confirmed cases of this coinfection in immunocompetent individuals during a period of 7 years (2015–2022) comparing them to a systematic review of 22 confirmed cases of the same coinfection from 1995 to 2014.http://dx.doi.org/10.1155/2023/6975041
spellingShingle Aayush Adhikari
Surendra Khanal
Sagar Rana Magar
Srijana Thapa
Srijana Khati
Rajan Lamichhane
Kundan Marasini
Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature
Case Reports in Infectious Diseases
title Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature
title_full Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature
title_fullStr Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature
title_full_unstemmed Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature
title_short Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature
title_sort aspergillus coinfection in a hydatid cyst cavity of lung in an immunocompetent host a case report and review of literature
url http://dx.doi.org/10.1155/2023/6975041
work_keys_str_mv AT aayushadhikari aspergilluscoinfectioninahydatidcystcavityoflunginanimmunocompetenthostacasereportandreviewofliterature
AT surendrakhanal aspergilluscoinfectioninahydatidcystcavityoflunginanimmunocompetenthostacasereportandreviewofliterature
AT sagarranamagar aspergilluscoinfectioninahydatidcystcavityoflunginanimmunocompetenthostacasereportandreviewofliterature
AT srijanathapa aspergilluscoinfectioninahydatidcystcavityoflunginanimmunocompetenthostacasereportandreviewofliterature
AT srijanakhati aspergilluscoinfectioninahydatidcystcavityoflunginanimmunocompetenthostacasereportandreviewofliterature
AT rajanlamichhane aspergilluscoinfectioninahydatidcystcavityoflunginanimmunocompetenthostacasereportandreviewofliterature
AT kundanmarasini aspergilluscoinfectioninahydatidcystcavityoflunginanimmunocompetenthostacasereportandreviewofliterature