• 대한영상의학회지
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• 제81권6호
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• pp.1529-1536
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• 2020

침습성 폐 아스페르길루스증은 주로 면역저하 환자에서 발생하는 것으로 알려져 있지만 드물게 면역저하가 없는 환자에서도 발생한다. 면역저하가 없는 환자에서 발병하는 경우, 초기에 진균에 의한 폐 감염을 의심하기가 어렵기 때문에 진단 및 치료가 늦어지고 나쁜 예후를 보일 수 있다. 저자들은 면역저하가 없는 29세 남성 환자에서 선천성 심장질환 수술 후 발생한 침습성 폐 아스페르길루스증의 사례가 있어 시간 경과에 따른 CT 소견과 함께 보고하고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제59권3호
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• pp.311-314
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• 2005

저자들은 좌상엽 기관지를 막아 종양을 형성하여 폐암으로 오인된 기관지내 아스페르길루스증 1예를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제77권1호
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• pp.28-33
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• 2014

We report a case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 70-year-old woman was hospitalized for dyspnea. She had been well controlled for her diabetes mellitus and hypertension. The chest X-ray disclosed mediastinal widening, and the computed tomography scan of the chest showed that there was a large mediastinal mass and this lesion extended into the left atrium and right bronchus. The cardiac echocardiography showed that a huge mediastinal cystic mass compressed in the right atrium and a hyperechoic polypoid lesion in the left. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which was stained with periodic acid-Schiff and Gomori's methenamine silver. Despite the treatment with antifungal agents, she died from cardiac tamponade after three months. Invasive pulmonary aspergillosis, which involves the mediastinum and the heart, is very rare in immunocompetent patients.

• Journal of Microbiology and Biotechnology
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• 제24권8호
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• pp.1044-1050
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• 2014

Since there is no consensus about the most reliable assays to detect invasive aspergillosis from samples obtained by minimally invasive or noninvasive methods, we compared the efficacy of an enzyme-linked immunosorbent assay (ELISA) for galactomannan (GM) detection and quantitative real-time PCR assay (qRT-PCR) for the diagnosis of invasive pulmonary aspergillosis. Neutropenic, male Sprague-Dawley rats (specific pathogen free; 8 weeks old; weight, $200{\pm}20g$) were immunosuppressed with cyclophosphamide and infected with Aspergillus fumigatus intratracheally. Tissue and whole blood samples were harvested on days 1, 3, 5, and 7 post-infection and examined with GM ELISA and qRT-PCR. The A. fumigatus DNA detection sequence was detected in the following number of samples from 12 immunosuppressed, infected rats examined on the scheduled days: day 1 (0/12), day 3 (0/12), day 5 (6/12), and day 7 (8/12) post-infection. The sensitivity and specificity of the qRT-PCR assay was 29.2% and 100%, respectively. Receiver operating characteristic curve (ROC) analysis indicated a Ct (cycle threshold) cut-off value of 15.35, and the area under the curve (AUC) was 0.627. The GM assay detected antigen in sera obtained on day 1 (5/12), day 3 (9/12), day 5 (12/12), and day 7 (12/12) post-infection, and thus had a sensitivity of 79.2% and a specificity of 100%. The ROC of the GM assay indicated that the optimal Ct cut-off value was 1.40 (AUC, 0.919). The GM assay was more sensitive than the qRT-PCR assay in diagnosing invasive pulmonary aspergillosis in rats.

• Tuberculosis and Respiratory Diseases
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• 제45권1호
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• pp.197-203
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• 1998

Invasive pulmonary aspergillosis is a disease occuring predominantly in patients with defects in immunity such as neutropenia, hematologic malignancies or with defects in cell-mediated immunity. The isolation of Aspergillus from respiratory tract of normal host usually signifies tracheobronchial colonization, making this diagnosis difficult. There are isolated case reports occuring in normal hosts but most of them were diagnosed postmortem at autopsies indicating that early diagnosis of invasive aspergillosis in normal host is difficult. We describe here a case of invasive aspergillosis in a immunocompetent host diagnosed by lung biopsy which was successfully treated with Amphotericin-B. Invasive pulmonary aspergillosis should be included as one of the differential diagnosis if a patient with pneumonic consolidation does not respond to usual therapy, even if the patient does not have any defect in immunity.

• Parasites, Hosts and Diseases
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• 제52권4호
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• pp.425-428
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• 2014

A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.

• The Korean Journal of Legal Medicine
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• 제42권4호
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• pp.164-167
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• 2018

Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.

• Journal of Korean Neurosurgical Society
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• 제37권2호
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• pp.146-149
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• 2005

Most primary spinal abscesses, irrespective of pathogens and anatomical locations, have better prognosis than that of secondary abscesses with spondylitis. We report a 68-year-old man, previously undertaken pulmonary resection due to tuberculosis, presented with paraparesis. Imaging studies showed primary intraspinal abscesses at T-1 and T-3 vertebral levels, semi-invasive pulmonary Aspergillosis and inflammation of the posterior mediastinum. Operative procedure and histopathological examination revealed interdural Aspergillus abscess. Despite chemotherapy, he deteriorated progressively, and spondylitis developed at corresponding vertebrae. He eventually died 6 weeks postoperatively due to pulmonary complication. The authors intended to inform that such an extradural inflammatory lesion of Aspergillus abscess should be treated carefully.

• Tuberculosis and Respiratory Diseases
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• 제63권3호
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• pp.278-282
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• 2007

거짓막 괴사성 기관지 아스페르길루스증은 심한 면역 저하가 있는 환자에서 발생하는 드문 질환으로 높은 사망률을 보이고 있다. 저자들은 당뇨병 외에는 과거력이 없는 고령의 환자에서 거짓막 괴사성 기관지 아스페르길루스증을 1예 진단하였으며 적절한 치료로 호전되어 문헌고찰과 함께 보고하는 바이다.

• 대한영상의학회지
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• 제83권3호
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• pp.737-743
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• 2022

아스페르길루스 기관-기관지염은 침습성 폐 아스페르길루스의 매우 드문 형태 중 하나로 주로 기관-기관지에 국한되어 거짓막이나 궤양을 형성하거나 폐쇄를 유발하는 질환이다. 거짓막성 아스페르길루스 기관-기관지염은 아스페르길루스 기관-기관지염 중 가장 심한 형태로 대게는 면역저하자에서 발병하고 예후가 좋지 않다. 현재까지 이 질환에 대해 몇 개의 국내보고가 있으나 영상 소견에 대한 보고는 드물다. 이에 저자들은 기관지경 검사상 거짓막성 아스페르길루스 기관-기관지염으로 진단되고 적절한 항진균제 투여로 성공적으로 치료된 환자의 증례를 특징적인 영상 소견과 함께 보고하고자 한다.