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A Case of Fatal Tracheobronchial Aspergillosis in a Neutropenic Patient
Jae Cheol Kwon, M.D., Myoung Joon Song, M.D., Ki Jo Kim, M.D., Yoo Kyoung Oh, M.D., Sung-Yong Kim, M.D., Sun Hee Park, M.D., Su Mi Choi, M.D., Dong-Gun Lee, M.D., Seok Lee, M.D., Wan-Shik Shin, M.D. and Chun-Choo Kim, M.D.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Vol.36 Num.1 (p54~58)
Tracheobronchial aspergillosis is an uncommon clinical form of invasive aspergillosis, particularly found in patients with AIDS and in lung transplant recipients than in other immunocompromised patients. The rapidity of the disease progression can result in fatal airway obstruction in a short period of time that the patient may need emergency tracheostomy without knowing the cause of the obstruction. We describe a case of fatal tracheobronchial aspergillosis which developed in a 43- year-old female patient with acute lymphoblastic leukemia. Dyspnea and stridor developed on the 20th day after 2nd consolidation chemotherapy, which was during the prolonged neutropenic period. Airway narrowing was observed on the computed tomograph scan of neck and emergency tracheostomy was performed. Infiltration with aspergillus hyphae was found in the tracheal ring and bronchial mucosa. Despite the use of amphotericin B, the patient died of bleeding and airway obstruction.
Keywords : Aspergillosis, Neutropenia, Trachea, Bronchi