Ağca Meltem, Arinç Sibel, Yilmaz Aynur, Güney Cengiz, Akel Gülcihan, Karagöz Turan
Süreyyapaşa Gögüs Hastaliklari ve Göğüs Cerrahisi Eğitim ve Araştirma Hastanesi, IV. Göğüs Hastaliklari Kliniği, Istanbul.
Mikrobiyol Bul. 2008 Jan;42(1):157-61.
Infections caused by Aspergillus spp. in immunocompromised or atopic patients may present as invasive aspergillosis, allergic bronchopulmonary aspergillosis and aspergilloma. In this report a 69 years old female patient admitted to the hospital with the complaints of intermittent cough and sputum and diagnosed as endonbronchial aspergilloma, has been presented. The patient was not immunocompromised, however she has bronchial asthma for 10 years and the disease is now under control. The chest radiography and computed tomography revealed lung infiltration with undefined borders, and bronchoscopy demonstrated the presence of a mass at left lower lobe. In the pathologic examination of biopsy specimen with the use of methenamine silver and PAS methods, hyphae formations concordant with Aspergillus were detected. The direct microscopic examinations of biopsy material and sputum obtained after bronchoscopy, have also revealed the presence of hyphae. A. fumigatus was isolated from the cultures of biopsy material and sputum specimen. The patient was diagnosed as endonbronchial aspergilloma, however the follow-up was failed since she has not accepted medical or surgical treatment. In conclusion, aspergilloma should be considered in the differential diagnosis of mass lesions in the endobronchial area.
曲霉属感染在免疫功能低下或特应性患者中可能表现为侵袭性曲霉病、变应性支气管肺曲霉病和曲菌球。在本报告中，介绍了一名69岁女性患者，因间歇性咳嗽和咳痰入院，被诊断为支气管内曲菌球。该患者免疫功能正常，但患有支气管哮喘10年，目前病情得到控制。胸部X线和计算机断层扫描显示肺部有边界不清的浸润影，支气管镜检查显示左下叶有肿物。在活检标本的病理检查中，采用六胺银和PAS方法，检测到与曲霉相符的菌丝形成。支气管镜检查后获取的活检材料和痰液的直接显微镜检查也显示有菌丝存在。从活检材料和痰液标本培养物中分离出烟曲霉。该患者被诊断为支气管内曲菌球，但由于她未接受药物或手术治疗，未能进行随访。总之，在支气管内区域肿块病变的鉴别诊断中应考虑曲菌球。
