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Chest Infections |

Hydatid Pulmonary Cyst Overinfected With Aspergillus

Alexandru-Mihail Botianu*, MD; Petre Vlah-Horea Botianu, MD
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University of Medicine and Pharmacy, Tirgu-Mures, Romania


Chest. 2012;142(4_MeetingAbstracts):249A. doi:10.1378/chest.1390008
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Abstract

SESSION TYPE: Infectious Disease Global Case Report Posters

PRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PM

INTRODUCTION: We present a combination of two rare diseases of the lung.

CASE PRESENTATION: We report a 28 years old female pacient complaining of fever, dyspnea and hemoptysis. CXR and CT scan revealed an 8 cm left upper lobe lesion, with imaging aspect suggesting a suppurated hydatid cyst. Surgery was performed, with cystectomy, excision of the pericyst and cappitonage. Due to the macroscopic aspect, a mycologic examination of the pus was requested, which showed the showed the presence of Aspergillus spp. The patient remained febrile after surgery, with no obvious cause. The postoperative course was favourable, with resolution of the fever after the introduction of specific antifungal treatment (voriconasole) on day 5 after surgery. The patient was discharged on the postoperative day 20. At 3 years after surgery she presents with no thoracic complaints and no sequelae.

DISCUSSION: This rare case shows that fungal infection can develop on hydatid disease. The presence of Aspergillus spp. was demonstrated by both the mycologic and pathologic examinations, as well as by the resolution of fever after the introduction of specific antifungal treatment.

CONCLUSIONS: In cases of suppurated pulmonary hydatid cysts, mycologic examination allows detection of fungal infections, allowing a specific therapy which prevents further complications.

1) Pagès PB, Abou Hanna H, Caillot D, Bernard A. Place of surgery in pulmonary aspergillosis and other pulmonary mycotic infections, Rev Pneumol Clin. 2012; 68(2):67-76

2) Lejay A, Falcoz PE, Santelmo N, Helms O, Kochetkova E, Jeung M, Kessler R, Massard G. Surgery for aspergilloma: time trend towards improved results? Interact Cardiovasc Thorac Surg. 2011;13(4):392-5

3) Gürel D, Kargi A, Unlü M, Sanli A, Yilmaz E. Aspergillus colonization of an echinococcal cyst cavity: case report. Turk Patoloji Derg 2011; 27(3):263-5

DISCLOSURE: The following authors have nothing to disclose: Alexandru-Mihail Botianu, Petre Vlah-Horea Botianu

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University of Medicine and Pharmacy, Tirgu-Mures, Romania

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