TY - JOUR
A2 - Taliani, Gloria
AU - Seitz, Tamara
AU - Hoepler, Wolfgang
AU - Neuhold, Stephanie
AU - Wenisch, Christoph
PY - 2019
DA - 2019/12/16
TI - Acute Pulmonary Aspergillosis as a Severe Complication of Influenza, Pneumococcal Pneumonia, and Staphylococcus aureus Bacteremia in ICU
SP - 3021742
VL - 2019
AB - 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.
SN - 2090-6625
UR - https://doi.org/10.1155/2019/3021742
DO - 10.1155/2019/3021742
JF - Case Reports in Infectious Diseases
PB - Hindawi
KW -
ER -