Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU
Background. Acute aspergillosis is a disease with dramatic progression and high mortality if not treated rapidly. However, diagnosing and treating is challenging, as the risk factors are not fully understood. Case Presentation. A fifty-three-year-old woman without any comorbidities was admitted to h...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/3021742 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832552873742827520 |
|---|---|
| author | Tamara Seitz Wolfgang Hoepler Stephanie Neuhold Christoph Wenisch |
| author_facet | Tamara Seitz Wolfgang Hoepler Stephanie Neuhold Christoph Wenisch |
| author_sort | Tamara Seitz |
| collection | DOAJ |
| description | Background. Acute aspergillosis is a disease with dramatic progression and high mortality if not treated rapidly. However, diagnosing and treating is challenging, as the risk factors are not fully understood. Case Presentation. A fifty-three-year-old woman without any comorbidities was admitted to hospital due to high fever. Infections with influenza and pneumonia and Staphylococcus aureus bacteremia were diagnosed. The patient improved at first due to antimicrobial therapy; nine days after admission, her clinical condition deteriorated again, and she was transferred to ICU due to septic shock accompanied by respiratory failure, necessitating mechanical ventilation and high-dose catecholamine support. A CT scan showed a resolving inflammatory infiltrate bilateral caverns with markedly thickened walls. A culture from a bronchoalveolar lavage grew Aspergillus fumigatus. Galactomannan testing was positive in a bronchoalveolar lavage sample, and beta-D-glucan was positive in serum. Antifungal therapy with voriconazole and intermittent isavuconazole due to renal failure was performed, followed by a surgical resection of the caverns. Patient’s recovery was complicated by several severe bleeding episodes in the lungs. However, the patient showed full recovery and was discharged after 109 days in hospital. Conclusions. This case report highlights multiple complications of influenza and the difficulties of diagnosing and treating acute pulmonary aspergillosis. Furthermore, it stresses the importance for further studies to deepen the understanding about the association between influenza and aspergillosis and to shed further light on adequate therapy. |
| format | Article |
| id | doaj-art-aac586cf767b495e8ba69c5e60d48f30 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-aac586cf767b495e8ba69c5e60d48f302025-02-03T05:57:37ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/30217423021742Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICUTamara Seitz0Wolfgang Hoepler1Stephanie Neuhold2Christoph Wenisch3Department of Infectious Diseases and Tropical Medicine, SMZ Süd Vienna, Kundratstraße 3, Vienna 1100, AustriaDepartment of Infectious Diseases and Tropical Medicine, SMZ Süd Vienna, Kundratstraße 3, Vienna 1100, AustriaDepartment of Infectious Diseases and Tropical Medicine, SMZ Süd Vienna, Kundratstraße 3, Vienna 1100, AustriaDepartment of Infectious Diseases and Tropical Medicine, SMZ Süd Vienna, Kundratstraße 3, Vienna 1100, AustriaBackground. Acute aspergillosis is a disease with dramatic progression and high mortality if not treated rapidly. However, diagnosing and treating is challenging, as the risk factors are not fully understood. Case Presentation. A fifty-three-year-old woman without any comorbidities was admitted to hospital due to high fever. Infections with influenza and pneumonia and Staphylococcus aureus bacteremia were diagnosed. The patient improved at first due to antimicrobial therapy; nine days after admission, her clinical condition deteriorated again, and she was transferred to ICU due to septic shock accompanied by respiratory failure, necessitating mechanical ventilation and high-dose catecholamine support. A CT scan showed a resolving inflammatory infiltrate bilateral caverns with markedly thickened walls. A culture from a bronchoalveolar lavage grew Aspergillus fumigatus. Galactomannan testing was positive in a bronchoalveolar lavage sample, and beta-D-glucan was positive in serum. Antifungal therapy with voriconazole and intermittent isavuconazole due to renal failure was performed, followed by a surgical resection of the caverns. Patient’s recovery was complicated by several severe bleeding episodes in the lungs. However, the patient showed full recovery and was discharged after 109 days in hospital. Conclusions. This case report highlights multiple complications of influenza and the difficulties of diagnosing and treating acute pulmonary aspergillosis. Furthermore, it stresses the importance for further studies to deepen the understanding about the association between influenza and aspergillosis and to shed further light on adequate therapy.http://dx.doi.org/10.1155/2019/3021742 |
| spellingShingle | Tamara Seitz Wolfgang Hoepler Stephanie Neuhold Christoph Wenisch Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU Case Reports in Infectious Diseases |
| title | Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU |
| title_full | Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU |
| title_fullStr | Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU |
| title_full_unstemmed | Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU |
| title_short | Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU |
| title_sort | acute pulmonary aspergillosis as a severe complication of influenza pneumococcal pneumonia and staphylococcus aureus bacteremia in icu |
| url | http://dx.doi.org/10.1155/2019/3021742 |
| work_keys_str_mv | AT tamaraseitz acutepulmonaryaspergillosisasaseverecomplicationofinfluenzapneumococcalpneumoniaandstaphylococcusaureusbacteremiainicu AT wolfganghoepler acutepulmonaryaspergillosisasaseverecomplicationofinfluenzapneumococcalpneumoniaandstaphylococcusaureusbacteremiainicu AT stephanieneuhold acutepulmonaryaspergillosisasaseverecomplicationofinfluenzapneumococcalpneumoniaandstaphylococcusaureusbacteremiainicu AT christophwenisch acutepulmonaryaspergillosisasaseverecomplicationofinfluenzapneumococcalpneumoniaandstaphylococcusaureusbacteremiainicu |