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Korean J Crit Care Med > Volume 28(1); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(1): 67-71. doi: https://doi.org/10.4266/kjccm.2013.28.1.67
급성 기도 폐쇄와 호흡 부전을 유발한 아스페르길루스 기관지염 1예
고유상ㆍ임소연ㆍ서지영ㆍ전경만ㆍ한서구*
성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과, *오산한국병원 호흡기내과
Airway Obstruction and Respiratory Failure Due to Aspergillus Tracheobronchitis
Yousang Ko, So Yeon Lim, Gee Young Suh, Kyeongman Jeon, Seo Goo Han
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Osan Hankook Hospital, Osan, Korea. westernhan@gmail.com
ABSTRACT
Invasive aspergillosis is a serious threat and a leading cause of death in immunocompromised patients. Aspergillus tracheobronchitis is an infrequent but severe form of invasive pulmonary aspergillos in which the fungal infection is entirely or predominantly confined to the tracheobronchial tree. We report an extraordinary case of acute airway obstruction and respiratory failure due to Aspergillus tracheobronchitis in an immunocompromised patient. Fiberoptic bronchoscopy revealed extensive obstruction of both the main and lobar bronchus with yellowish nodules strongly adhered to the bronchial wall; both histologic examination and culture of these nodules revealed Aspergillus fumigatus. Even with early detection of an intraluminal growth of Aspergillus and prompt institution of antifungal therapy, the patient died of refractory hypoxemia a few days later. This report shows that Aspergillus tracheobronchitis should be considered in immunocompromised patients with suspected lung infection even when the main radiographic finding is atelectasis.
Key Words: acute respiratory failure; airway obstruction; Aspergillus tracheobronchitis; atelectasis
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