Author/Authors :
Moreno-Gonzalez, Gabriel Intensive Care Unit - Bellvitge University Hospital - Hospitalet de Llobregat, Barcelona, Spain , Ricart de Mesones, Antoni Intensive Care Unit - Bellvitge University Hospital - Hospitalet de Llobregat, Barcelona, Spain , Tazi-Mezalek, Rachid Bronchoscopy Department - Bellvitge University Hospital, Barcelona, Spain , Marron-Moya, Maria Teresa Forensic Laboratory - Institute of Legal Medicine of Catalunya, Barcelona, Spain , Rosell, Antoni Bronchoscopy Department - Bellvitge University Hospital, Barcelona, Spain , Mañez, Rafael Intensive Care Unit - Bellvitge University Hospital - Hospitalet de Llobregat, Barcelona, Spain
Abstract :
Invasive pulmonary aspergillosis (IPA) is a rare pathology with increasing incidence mainly in critical care settings and recently
in immunocompetent patients. The mortality of the disease is very high, regardless of an early diagnosis and aggressive treatment.
Here, we report a case of a 56 yr old previously healthy woman who was found unconscious at home and admitted to the emergency
room with mild respiratory insufficiency. In the first 24 hours she developed an acute respiratory failure with new radiographic
infiltrates requiring Intensive Care Unit admission. A severe obstructive pattern with impossibility of ventilation because of bilateral
atelectasis was observed, requiring emergent venovenous extracorporeal membrane oxygenator device insertion. Bronchoscopy
revealed occlusion of main bronchi, demonstrating by biopsy an invasive infection by Aspergillus fumigatus and A. flavus. Despite
an aggressive treatment and vital support the patient had a fatal outcome. The forensic study confirms the diagnosis of IPA but also
revealed the presence of disseminated aspergillosis.
