Jiang Yuying, Gohara Amira F, Mrak Robert E, Muldrew Kenneth L
Department of Pathology, University of Toledo Medical Center, Toledo, OH 43614, USA.
Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA.
Case Rep Infect Dis. 2020 Jun 21;2020:9727513. doi: 10.1155/2020/9727513. eCollection 2020.
Aspergillosis is a commonly diagnosed fungal infection. Histopathologic examination alone can have diagnostic pitfalls due to the overlapping of fungal morphology. We report a case of infection initially misdiagnosed as aspergillosis. The patient presented to the hospital with shortness of breath and chest and abdominal pain. Laboratory tests revealed leukocytosis and elevated serum liver enzymes, myoglobin and lipase. He died of hypotensive shock and brain abscesses despite antibiotic treatment. Autopsy revealed invasive fungal infection in the heart, thyroid, and brain with presence of 45-degree angled, branching hyphae. The initial diagnosis of aspergillosis was made; however, further molecular studies identified the organism as . This report reveals the potential pitfalls of morphologic diagnosis alone; and the necessity of other testing modalities to render an accurate diagnosis which is crucial for appropriate.
曲霉病是一种常见的诊断出的真菌感染。仅组织病理学检查可能因真菌形态重叠而存在诊断陷阱。我们报告一例最初被误诊为曲霉病的感染病例。该患者因呼吸急促、胸痛和腹痛入院。实验室检查显示白细胞增多以及血清肝酶、肌红蛋白和脂肪酶升高。尽管接受了抗生素治疗，他仍死于低血压休克和脑脓肿。尸检显示心脏、甲状腺和脑部存在侵袭性真菌感染，有呈45度角分支的菌丝。最初诊断为曲霉病；然而，进一步的分子研究确定该病原体为 。本报告揭示了仅靠形态学诊断的潜在陷阱；以及采用其他检测方法以做出准确诊断的必要性，这对于恰当治疗至关重要。 （原文中“identified the organism as.”后面缺失具体内容）
