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Erschienen in:
13.05.2016 | Imaging in Intensive Care Medicine
Severe ARDS in a critically ill influenza patient with invasive pulmonary aspergillosis
Erschienen in: Intensive Care Medicine | Ausgabe 10/2016
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A 63-year-old previously healthy woman presented to the hospital with fever, breathlessness, and abdominal pain for 6 days. She reported a history of successfully treated breast cancer 5 years ago (surgery and chemotherapy) and 37 pack-years of smoking. In the following days she developed a severe ARDS. Bronchoscopy showed multiple tracheal ulcerations (Fig. 1a). The performed transbronchial biopsy, BAL cultures, and PCR revealed influenza A, parainfluenza 4 virus, and an invasive aspergillus (IA) fumigatus infection (Fig. 1b). Serum aspergillus galactomannan antigen levels were 1.5 ng/mL. CTs of the thorax showed progressive bilateral cavities over the following days (Fig. 1c, d). Despite full intensive care, including antiviral and antifungal treatment, the patient died of the severe ARDS.
Fig. 1
a Multiple tracheal ulcerations on day 3. b Histology of lung parenchyma with invasive pulmonary aspergillosis (arrow). c CT scan of the lungs on day 4 showing bilateral alveolar and peribronchial lesions compatible with invasive aspergillosis. d CT scan of the lungs on day 11 showing progressive bilateral cavities
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