A Case of Pulmonary Aspergillus Infection in with a Patient Renal Failure

Special Article - Mycology

J Bacteriol Mycol. 2019; 6(2): 1097.

A Case of Pulmonary Aspergillus Infection in with a Patient Renal Failure

Sahin R*

Mersin City Hospital, Mersin, Turkey

*Corresponding author: Sahin R, Mersin City Hospital, Mersin, Turkey

Received: January 07, 2019; Accepted: January 24, 2019; Published: January 31, 2019

Abstract

Invasive aspergillosis caused by Aspergillus spp is seen in immunocompromised hosts and has a poor prognosis. We report a case of pulmonary aspergillosis in a 84-year-old male who had cough, respiratory distress symptoms and a history of primary hypertension, chronic obstructive pulmonary disease, and unspecified chronic renal failure. In the microscopy of deep tracheal aspirate specimen taken from the patient was seen rare leukocytes (PMNL), 1-2 epithelial cells, yeast and hyphae. Aspergillus spp grew in the culture of deep tracheal aspirate sample, the results of the biochemical parameters were as follows: BUN: 132.7mg/dl, creatinine: 3.39mg/dl, CRP: 4.18mg/L, procalcitonin: 0.60ng/ml, calcium: 7.87mg/dl. Other results were found in the normal range. The patient was treated in the nephrology department.

Keywords: Aspergillus spp; Renal Failure; Pulmonary Aspergillosis

Introduction

Aspergillus spp is a fungus that can cause invasive disease in immunocompromised patients. Aspergillus fumigatus is the most common isolate obtained in 70-90% of invasive aspergillosis (IA) cases in immunocompromised patients. Aspergillus spp are mainly respiratory pathogens [1]. Invasive aspergillosis occurs predominantly in immunocompromised hosts, such as hematological malignancies, hematopoietic stem cell or solid organ transplants, congenital or acquired immunodeficiency, and other immunosuppressive drugs [2,3]. Infections are usually caused by hematogenous propagation through a focus, such as lung infection, or by direct extension from the paranasal sinuses rarely [4,5].

Case Presentation

We report a case of invasive pulmonary aspergillosis Figure 1, in a man with pre-diagnosis of chronic obstructive pulmonary disease, unspecified chronic renal failure, complaints of cough and respiratory distress at 84 years of age and primary hypertension, chronic obstructive lung disease, unspecified preliminary diagnoses. In the microscope of deep tracheal aspirate specimen taken from the patient; rare leukocytes (PMNL), 1-2 epithelial cells, yeast and hyphae were seen. Aspergillus spp grew on blood culture of deep tracheal aspirate specimen Figure 2, and it, was seen with methylene blue (Figure 3). The patient was treated at the nephrology department. Her blood level was 10g/dl, her white blood cell count (WBC) was 9850/mm³ and her platelet count was 222/mm³. The results of the biochemical parameters were as follows: BUN: 132.7mg/dl, creatinine: 3.39mg/ dl, CRP: 4.18mg/L, calcium: 7.87mg/dl. Other results were found in the normal rang. The initiation of therapy in pulmonary diseases, the patient was followed later in the nephrology service.