Cases reported "Lung Diseases, Fungal"

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1/5. Non-tuberculous mycobacterial lung infection complicated by chronic necrotising pulmonary aspergillosis.

    We report four cases of pulmonary mycobacterial disease (three due to Mycobacterium malmoense and one to Myco- bacterium avium intracellulare) complicated by the development of chronic necrotising pulmonary aspergillosis. Difficulties with treatment and the potential benefits of steroids are discussed.
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ranking = 1
keywords = avium
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2/5. Chronic necrotizing pulmonary aspergillosis complicated by a cavitary lesion caused by Pulmonary Mycobacterium-avium complex disease.

    A 66-year-old woman who had undergone one year's treatment for pulmonary nontuberculous mycobacterial disease due to Mycobacterium avium (rifampicin, ethambutol, clarithromycin, streptomycin-->levofloxacin) five years earlier was admitted to our hospital because of continuous fever and a newly detected abnormal chest shadow, which was like a fungus ball in the right upper lobe on chest computed tomography in the giant cavitary lesion caused by pulmonary Mycobacterium-avium complex (MAC) disease. A diagnosis of chronic necrotizing pulmonary aspergillosis (CNPA) complicated by pulmonary MAC disease was made because aspergillus niger was isolated from several sputum specimens, anti-aspergillus antibody was positive, and clinical symptoms such as fever, were disclosed with the radiological finding of a fungus ball-like shadow and an infiltration shadow around the cavity. The patient had received various forms of antifungal chemotherapy, but the clinical effect had been poor. Since then, she had been slowly worsening. Although mycetomas, with the typical appearance of a fungus ball on a chest radiograph, have been reported to easily form in cavitary lesions caused by previous pulmonary tuberculosis, we believe, as illustrated by the present case, that they could also form in such lesions caused by pulmonary MAC disease, since the frequency of pulmonary nontuberculous mycobacterial disease has recently been increasing in comparison with that of pulmonary tuberculosis.
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ranking = 6
keywords = avium
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3/5. Fatal hemoptysis from invasive aspergillus niger in a patient with cavitary lung disease and mycobacterium avium complex infection.

    Invasive aspergillosis typically afflicts immunocompromised patients, whereas pulmonary aspergilloma is a recognized complication of pre-existing cavitary lung disease in immunocompetent hosts. In both cases, the most prevalent pathogens are aspergillus fumigatus and aspergillus flavus. We describe a case of fatal hemoptysis from invasive aspergillus niger infection in the setting of bullous lung disease, steroid-treated sarcoidosis, and mycobacterium avium complex infection. This report highlights the potential for A. niger to cause invasive disease in conjunction with other pathologic processes in the lung.
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ranking = 5
keywords = avium
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4/5. Ankylosing spondylitis lung disease--an underdiagnosed entity?

    During the last 10 years, 14 cases of ankylosing spondylitis (AS) with upper lobe changes were diagnosed. This is certainly an underestimation, since AS is often not noted in the case records even when diagnosed. Two recent cases were earlier undiagnosed, and only on specific questioning did the patients admit symptoms, though they were both HLA B27 positive and had X-ray changes of the sacro-iliacal joints typical of the disease. Thus, if not carefully sought, the diagnosis can be missed. A literature review revealed 160 published cases. The lung lesions can be complicated by superinfections of fungi or non-tuberculous mycobacteria or even mycobacterium tuberculosis.
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ranking = 1.3955389578804
keywords = mycobacterium
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5/5. Polypoid bronchial lesions due to scedosporium apiospermum in a patient with mycobacterium avium complex pulmonary disease.

    A 69 yr old female was hospitalized for further examination of abnormal shadows on chest radiographs. She had a history of tuberculous pleurisy, rheumatoid arthritis and gold-induced interstitial pneumonia. On admission she still suffered from rheumatoid arthritis. A chest computed tomography scan on admission showed clusters of small nodules in subpleural regions of both lungs combined with bronchiectasis. mycobacterium avium complex was cultured repeatedly from the sputum. Bronchoscopic examination disclosed white-yellow polypoid lesions in the orifice of the left B4 bronchus. Cultures of the brushing specimen of the polypoid lesions and bronchial aspirates from the B4 bronchus yielded smoky-grey mycelial colonies that were later identified as scedosporium apiospermum. It was concluded that the polypoid bronchial lesions due to scedosporium apiospermum were formed in the preexisting dilated bronchus caused by mycobacterium avium complex pulmonary disease.
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ranking = 6
keywords = avium
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