Tuberc Respir Dis.  2012 May;72(5):448-451.

Invasive Aspergillosis Involving the Lungs and Brain after Short Period of Steroid Injection: A Case Report

• Choi YR
• Kim JT
• Kim JE
• Jung HW
• Choe KH
• Lee KM
• An JY

Abstract

Invasive pulmonary aspergillosis (IPA) has emerged as a severe infection in patients with immunocompromised hosts. However, recently, several IPA cases, without an apparent predisposition to immunodeficiency, has been reported. A 72-year-old woman was admitted for evaluation of general weakness and poor oral intake. She reported no medical history, except for intraarticular injection of a corticosteroid for joint pain for the duration of two months. A chest radiography revealed multiple cavitary nodules in both lungs. Examination of specimens, obtained by percutaneous needle biopsy, led to a diagnosis of invasive aspergillosis. Brain magnetic resonance imagining revealed numerous peripheral thin enhancing cystic nodules in both cerebral hemispheres. We initiated intravenous administration of amphotercin B. However, the patient died after nine days. Here, we report an invasive aspergillosis case, which involves the lungs and brain after a short period of steroid injection.

Keyword

Invasive Pulmonary Aspergillosis; Lung; Brain; Steroids

MeSH Terms

Administration, Intravenous
Aged
Arthralgia
Aspergillosis
Biopsy, Needle
Brain
Cerebrum
Female
Humans
Immunocompromised Host
Injections, Intra-Articular
Invasive Pulmonary Aspergillosis
Lung
Magnetic Resonance Spectroscopy
Steroids
Thorax
Steroids

Figure

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  Figure 1 Chest X-ray findings. (A) At admission. Chest X-ray revealed multiple cavitary nodules in both lungs. (B) At hospital 6 days. Chest X-ray revealed aggravating state of nodules and haziness in both lungs.

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  Figure 2 Chest computed tomography (CT) findings. Chest CT revealed multiple cavitary nodules and masses in both lungs.

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  Figure 3 Brain magnetic resonance imaging (MRI) findings. Brain MRI revealed numerous peripheral thin enhancing cystic nodules in right and left cerebral hemispheres.

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  Figure 4 Histologic finding shows an aggregate of fungal hypae with acute angle branching and rare fruiting body (GMS stain, ×400).

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