Surgical management of Aspergillus colonization associated with lung hydatid disease (original) (raw)
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Aspergillus colonization in hydatid cyst: Addition of a case
Lung India, 2013
Aspergillus is a common saprophytic fungus that causes invasive or non-invasive disease in humans. It commonly colonizes pre-existing lung cavities. It has been earlier reported to coexist in previously operated or ruptured hydatid cysts. However there have been only few case reports of its occurrence in previously unoperated cysts in immunocompetent hosts. The present case adds to this category.
Clinical medicine insights. …, 2011
BackgroundHydatid disease is rare in the United States. Rarely the hydatid cyst can become infected with mycotic organisms, such as Aspergillus. We describe a young male who presents with clinical features of suppurative lung abscess whose workup diagnosed hydatid cyst complicated by Aspergillus co-infection.Case presentationA 27-year-old Peruvian male was hospitalized because of fever, chills, and productive cough of three months’ duration. Clinical features were consistent with a suppurative lung abscess. Significant findings included leukocytosis with eosinophilia and a chest x-ray showing a large lingular lobe thick-walled cavity with a wavy irregular fluid level. The patient ultimately underwent surgical resection of the lingular lobe. Examination of the surgical specimen revealed the cavity to be a hydatid cyst. Histologic examination of the cyst wall showed intense inflammation and several septate hyphae of Aspergillus species. The patient recovered fully and has remained in good health.ConclusionA thick-walled cavity and a wavy meniscus constitute unusual features for an ordinary pyogenic lung abscess and suggests other possibilities. Endogenous cases of hydatid disease are uncommon in the United States, with the majority of cases occurring in immigrants. There are few published case reports describing incidental findings of Aspergillus in a hydatid cyst. The rare occurrence of such a condition can lead to a delay in diagnosis and treatment.
Coinfection of Pulmonary Hydatid Cyst and Aspergilloma: Case Report and Systematic Review
Aspergilloma infection consists of a mass of fungal hyphae, inflammatory cells, fibrin, mucus, and tissue debris and can colonize lung cavities due to underlying diseases such as tuberculosis, sarcoidosis, bronchiectasis, cavitary lung cancer, neoplasms, ankylosing spondylitis, bronchial cysts, and pulmonary infarction. Here we report coinfection of pulmonary hydatid cyst and aspergilloma in a 34-year-old female who had had history of minor thalassemia and suffered from chest pain, dyspnea, non-productive cough for at least five months, and hemoptysis for 20 days.
Pulmonary Hydatid Cysts Masquareading As Aspergilloma Lung: A Case Report
A 25-year-old female presented with cough, hemoptysis and low grade fever of one-month duration. There was no history of pulmonary disease or immunosuppression. A chest radiograph show segmental consolidation in upper lobe of right lung. Computerized tomography (CT) scan revealed 5.2x4.7cm sized round to oval cavitary lesion with air crescent in right upper lobe associated surrounding tiny centrilobular nodule and peribronchial thickening. Possibility of secondary aspergillosis in a preexisting tuberculous cavity. Sputum tests for acid fast bacilli, bacteria and fungi, were all negative. The patient underwent resection of a upper lobe of right lung, and a wedge resection specimen was sent for histopathological examination in the department of pathology. Grossly a lung lobectomy specimen ms. 10x6x5 cm. On c/s cyst identified ms. 5x4 cm. in diameter was identified, it was unilocular white laminated and filled with clear fluid. Subsequent microscopic examination demonstrated that acellular laminated hyaline material (ectocyst), while surrounding lung parenchyma showed dense inflammatory infiltrate comprised of lymphocytes & giant cells, features consistent with hydatid cyst disease.
Aspergilloma in a Pulmonary Hydatid
World Journal of Cardiovascular Surgery, 2013
Aspergilloma infection in the lung can occur in preexisting cavities and is usually seen after tuberculosis, pulmonary infarction and bronchestasis. Occassionally aspergilloma has been reported within a hydatid cyst. We describe a patient with aspergilloma formed within cyst hydatid. The primary symptom in this patient was recurrent hemoptysis. In this 42-year-old male, the diagnosis was established by HRCT chest. Treatment consisted of postero-lateral thoracotomy with a bilobectomy of lower and middle lobe. Aspergilloma is an unusual complication of hydatid cyst and results from the deterioration of local defence against opportunistic infections.
Case Reports in Infectious Diseases
Aspergilloma (a saprophytic infection) typically colonizes lung cavities due to underlying diseases such as tuberculosis, bronchiectasis, cavitary lung cancer, sarcoidosis, and pulmonary infarctions. Rarely, aspergilloma has been noted within a hydatid cyst. Even if this was the case, it is more common to find the coexistence of aspergilloma and pulmonary echinococcal cysts in immunocompromised individuals. It is, however, very uncommon to find this coinfection in normal immune status individuals. Here, we report on the successfully treated case of a 30-year-old immunocompetent female from Western Nepal with histologically proven coinfection by these two pathogens. She had a prolonged history of exposure to domesticated dogs. She suffered from hemoptysis from time to time for 3 years with increased frequency in the last 30 days. She was misdiagnosed clinically during a past medical visit at a local health center. Her computed tomography (CT) scans showed well-defined nonenhancing cy...
Invasive Pulmonary Aspergillosis Mimicking Cyst Hydatics
Acta Medica, 2019
Invasive pulmonary aspergillosis (IPA) is a less frequent form and rarely has been reported in normal immune system cases. They do not constitute radiologically cystic structures. A 53-year-old male who was engaged in stock farming and agriculture has no additional disease or habit in the patient history that would compromise the immune system. In thorax computed tomography, a 11x8x10 cm diaphragmatic invasive cystic lesion was seen in the middle and lower lobes of the right lung, was reported that there may be hydatid cyst. The patient underwent right lower bilobectomy and diaphragm resection, diaphragm was reconstructed with a dual mesh. Histopathologic diagnosis was reported as invasive pulmonary aspergillosis. There was no complication or recurrence in the case in the 24-month follow-up period. Thus, a cure was provided for our patient with invasive pulmonary aspergillosis, which was coincidentally diagnosed by pathology in the postoperative period.
Pulmonary hydatid disease with coexistent aspergillosis: An incidental finding
Indian Journal of Medical Microbiology, 2013
cyst was made. Patient underwent surgery and specimen was sent for histopathological examination. Grossly, we received a cut open cystic structure measuring 8 8 cm devoid of contents [Figure 2a]. Histopathological examination of cyst wall revealed the laminated membrane of hydatid cyst along with Echinococcus hooklets and infi ltration of its wall with septate fungal hyphae with acute angle branching, consistent with aspergillosis [Figure 2b]. These fungal hyphae were positive with periodic acid-Schiff and Grocotts methenamine silver. Culture studies were positive for Aspergillus fumigatus. Discussion Hydatid cyst is a zoonotic disease most commonly caused by Echinococcus granulosus, while Echinococcus multilocularis is the most common cause of pulmonary involvement. Human beings acquire the disease by ingesting the parasite eggs and are the intermediate hosts. Liver and lungs are most commonly affected organ; however, infection can occur in any organ of the body. [2] Aspergillosis is a saprophytic fungal infection most commonly caused by A. fumigatus. Aspergillus may cause allergic pulmonary aspergillosis, aspergilloma, and semi-invasive and invasive aspergillosis. [3] Typically, aspergilloma develop in cavities formed as a result of tuberculosis, sarcoidosis, bronchiectasis and lung abscess. Immune suppression and structural pulmonary defects may predispose to this infection. There are only a few case reports in the literature on the coexistence of aspergillosis and echinococcosis. [4-8] Aspergillus tends to invade the blood vessels; therefore, the most common symptom in pulmonary aspergillosis is haemoptysis which was present in our patient as well. Such a coexistence of hydatid cyst with fungi resembling Aspergillus is extremely rare and has been documented in only few case reports till date. It is important that we do not confuse this condition with colonisation sometimes seen after hydatid cystectomy that is no different from aspergilloma forming in preformed lung cavities. [9] The pathogenesis of this association remains unknown, but the cavity needs to be in communication with the airways so that fungal spores can colonise the cavity space. Although patients with immune defi ciencies are prone to aspergillosis, the coexistence of Aspergillus and hydatid