Date: 7 February 2014
Copyright: n/a
Notes:
Patient JS (age 53) has chronic cavitary pulmonary aspergillosis and failed itraconazole therapy. After taking voriconazole for several months she relatively suddenly developed florid conjunctivitis which is attributable to voriconazole. This occurred without facial erythema, which is unusual. Voriconazole has been continued.
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Nodules and areas of atelectasis are seen at both bases. He later died.
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Further details
It is clearly a relatively small cavitary lesion, and the patient was almost asymptomatic. This response was a ‘stable’ response. The patient was included in the report Denning DW, Lee JY, Hostetler JS, Pappas P, Kauffman CA, Dewsnup DH, Galgiani JN, Graybill JR, Sugar AM, Catanzaro A, Gallis H, Perfect JR, Dockery B, Dismukes WE, Stevens DA, NIAID Mycoses Study Group multicenter trial of oral itraconazole therapy of invasive aspergillosis. Am J Med 1994; 97: 135-144.
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Well demarcated pulmonary infarction is well seen in this close-up of the lung at autopsy in a patient with histologically confirmed invasive aspergillosis. Angio invasion is characteristic of invasive aspergillosis, is associated with a worse prognosis, but is not always seen.
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This 83 year old man presented with weight loss to a lung cancer clinic in mid 2003.
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