Aspergilloma in a Pulmonary Hydatid (original) (raw)
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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.
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.
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.
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
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.
Surgical management of Aspergillus colonization associated with lung hydatid disease
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 2008
Colonization with Aspergillus sp. usually occurs in previously formed lung cavities. Cystectomy is a widely used surgical technique for hydatid lung disease that can also leave residual cavities and potentially result in aspergilloma. We present two cases of this rare entity and a case with Aspergillus sp. colonization of an existing ruptured hydatid cyst.
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...
Pulmonary hydatid disease with aspergillosis - an unusual association in an immunocompetent host
Turkish Journal of Pathology, 2017
Echinococcosis is a common cause of pulmonary cavities. aspergillus fumigatus, a saprophytic fungus, can colonise pulmonary cavities caused by tuberculosis, sarcoidosis, echinococcosis, bronchiectasis and neoplasms. infection by aspergillus is often seen in immunosuppressed cases. However, co-infection of aspergillus with pulmonary echinococcosis is unexpected and very unusual, especially in an immunocompetent patient. We present the case of a 45-year-old immunocompetent male who came with non-resolving pneumonia and fever for 8 months and dyspnoea since 15 days accompanied by recurrent episodes of hemoptysis since 5 days. Chest X Ray and Computed Tomography scan showed a cystic lesion in the middle lobe of the right lung. Middle lobectomy with video-assisted thoracoscopic surgery was performed and histopathology revealed ectocyst of Hydatid cyst which was also colonised by septate fungal hyphae exhibiting acute angled branching, morphologically consistent with aspergillus. Gomori Methanamine Silver and Periodic acid Schiff stains highlighted the hyphae of aspergillus as well as the lamellated membranes of ectocyst and an occasional scolex of Echinococcus. Sections from surrounding lung parenchyma also showed these fungal hyphae within an occasional dilated bronchus. Thus a diagnosis of dual infection of aspergillosis and Pulmonary Echinococcosis was established. The possibility of dual infection by a saprophytic fungus must be kept in mind while dealing with a case of a cavitary lesion in long-standing and non-resolving pneumonia, even in an immunocompetent patient. Establishing the correct diagnosis of aspergillosis with Echinococcosis is essential for proper and complete management.