Date: 21 January 2014
The chest is distorted by a deformity of the back and ribs.
Copyright: n/a
Notes:
This patient’s X-ray is complex. The chest is distorted by a deformity of the back and ribs. Substantial metalwork following a spinal fusion is in place to support the vertebral column and part of this overlies the heart and part of it crosses the left lung. The patient also has a portacath device in-situ over the right lung, which allows i.v. antibiotics to be given. A needle is in-situ inside the portacath device. An external drainage tube is currently in-situ in a large air cavity and left upper thorax. This cavity contains mostly air but there is some fluid with the fluid level at its base. Underneath this large pyopneumothorax is a normal component of left lower lobe. The heart is very substantially moved to the right of the lung because of a previous right lower lobe resection. There is no evidence of aspergillosis on this x-ray as it stands.
Images library
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Scanning electron micrograph of Aspergillus ochraceopetaliformis conidial heads
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Image D & E. A case of onychomycosis associated with Aspergillus ochraceopetaliformis as described in Nail infection by Aspergillus ochraceopetaliformis. Med Mycol. 2009 Mar 9:1-5, 2009, Brasch J, Varga J, Jensen JM, Egberts F & Tintelnot K
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Further details
Image 5. Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with 3 weeks off between successive pulses, for four pulses) and treatment was successful.
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This patient was 28 yr old with adult lymphocytic leukaemia. She received induction chemotherapy and this infection developed 2 days after recovering from neutropenia.
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Close-up image of the lesion on the left thigh showing a mat of hyphae over the wound.
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Eosinophilic mucin with A. flavus in the nasal cavity. Irregular crust of 2.5 cm from a patient diagnosed as allergic fungal sinusitis. Patient with allergic fungal sinusitis
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GMS stain of eosinophilic mucin reveals a darkly stained dichotomously branched A. flavus hyphae within cellular background. Patient with allergic fungal sinusitis
