Kim Taeyun, Jeon Yohan, Choi Hyunji, Lee Jin Young, Kim Jehun
Department of Pulmonology, Kosin University Gospel Hospital, Busan, South Korea.
Department of Pathology, Kosin University Gospel Hospital, Busan, South Korea.
Oxf Med Case Reports. 2019 Jun 28;2019(6):omz055. doi: 10.1093/omcr/omz055. eCollection 2019 Jun.
Endobronchial fungal infection (EBFI) is a rare form of pulmonary fungal infection that especially affects immunocompromised patients. Furthermore, EBFI resulting in obstruction of the main bronchus is extremely rare. With the development of bronchoscopic techniques, rare cases of EBFI have been reported. A 68-year-old female was referred to the Department of Pulmonology for confusion and obtundation. The patient was diagnosed with septic shock due to acute pyelonephritis followed by obstructive EBFI. We performed bronchoscopic biopsy and endobronchial aspiration for culture. Biopsy showed yeast-like fungus and grew in the culture. EBFI has been under-recognized because of difficulties in confirming the diagnosis. Endobronchial ultrasound-guided transbronchial needle aspiration and bronchoscopy are used to improve the diagnosis of thoracic infection, such as tuberculosis. The role of bronchoscopy in the diagnosis of infectious diseases of the trachea or main bronchi is expected to widen in the future.
支气管内真菌感染(EBFI)是一种罕见的肺部真菌感染形式,尤其影响免疫功能低下的患者。此外,导致主支气管阻塞的EBFI极为罕见。随着支气管镜技术的发展,已有EBFI罕见病例的报道。一名68岁女性因意识模糊和昏迷被转诊至呼吸内科。该患者因急性肾盂肾炎继而发生阻塞性EBFI而被诊断为感染性休克。我们进行了支气管镜活检和支气管内抽吸培养。活检显示为酵母样真菌,培养结果呈阳性。由于确诊困难,EBFI一直未得到充分认识。支气管内超声引导下经支气管针吸活检术和支气管镜检查用于改善胸部感染(如结核病)的诊断。预计未来支气管镜在气管或主支气管传染病诊断中的作用将得到拓展。