Date: 26 November 2013
This 24-year-old male with AML on chemotherapy developed recent onset fever and cough. A: Chest radiograph showing patchy air space consolidation involving both lungs.
Copyright:
With thanks to Dr Sanjay Sharma, Dept Radiodiagnosis , All India institute of Medical Sciences , New Delhi 110 029 India .
Notes:
This patient was proven to have airway invasive aspergillosis. Though similar appearances can be caused by active tubercular/ viral bronchiolitis and even aspiration pneumonia.
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Drug rashes: Drug interactions between steroids and anti-fungal drugs – (ecchymosis)
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Reference: Muco-cutaneous retinoid effects and facial erythema related to the novel triazole antifungal agent voriconazole. Denning, DW & Griffiths, CEM. Clin.Exp Dermatol 2001, 26(8), 648-53.
Courtesy of Dr D Denning, Wythenshawe Hospital, Manchester.(© Fungal Research Trust), ,
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Micrographs of A. niger conidia & conidial heads provided by Amaliya Stepanova, Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Micrographs of A. terreus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Patients has history of ABPA complicating long standing asthma. His total IgE has fluctuated between 2,200 and 4,600 KU/L, his Aspergillus IgE between 36.3 and 65.4 kAU/L and Aspergillus IgG from 87-154 mg/L. He has been taking long term itraconazole.
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