A case series on pulmonary and tissue aspergillosis
Keywords:Sinonasalpolyposis, chronic kidney disease, pulmonary tuberculosis, anasarca, polypectomy
Aspergilli species cause opportunistic fungal infection in immunocompromised individuals. Invasive aspergillosis is a highly fatal opportunistic infection that accounts for amajor risk to immunocompromised patients. Among these species, A.fumigatus is the main opportunistic pathogen followed by A.niger and A.flavus. In immunocompetent individuals, the effective innate immunity eliminates theinhaled conidia and Allergic bronchopulmonary aspergillosis and aspergilloma are the only infections noted in them. Thus,A.fumigatus was considered for years to beainfirm pathogen. With increase in the number of immunosuppressed patients, however, there has been a marked increase in fatal invasive aspergillosis, which is now the widespread mold infection. In this case series, we have described four cases of aspergillosis. Male preponderance is seen, commonly seen in 4th to 5th decade, 3 out of 4 cases are immunocompromised having diabetes, chronic kidney disease, past history of tuberculosis and only one case was not associated with any comorbid illness. In case 4, the recurrence of polypoidalsinosis itself could be a risk factor causing erosion of nasal mucosa and chronic secretion.The morphological features of intraluminal lesions were of prognostic value. Most of the Aspergillosis patients had a good prognosis with early diagnosis and effective antifungal therapy.It can bedeadly if not diagnosed and treated properly.Very rarely aspergillosis may occur in immunocompetent individuals, which urged us to point outthese cases. With studies suggesting surging incidence and mortality rates, early diagnosis and treatment are paramount to upgrade patient survival.
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