Aspergiloma en enfisema ampolloso, femenina de 21 años, reporte de caso clínico

Connie Kroll; Dayana Escobar; Julia Quezada; Ana Guevara

doi:10.17162/rccs.v17i2.2101

Authors

Connie Kroll Hospital de Especialidades Eugenio Espejo, Quito, Ecuador https://orcid.org/0000-0002-8687-1135
Dayana Escobar Establecimiento de Salud Juan de Velasco, Colta, Ecuador https://orcid.org/0009-0005-9413-7538
Julia Quezada Centro de salud Güel, Azuay, Ecuador https://orcid.org/0009-0008-2374-6100
Ana Guevara Hospital Pablo Arturo Suárez, Quito, Ecuador https://orcid.org/0000-0002-5076-7889

DOI:

https://doi.org/10.17162/rccs.v17i2.2101

Keywords:

Bulla, Thoracotomy, Pneumonectomy, Voriconazole

Abstract

Case Presentation: We present the case of a 21-year-old female patient with a history of polycystic ovary syndrome, kyphoscoliosis, and rhinoplasty. She initially presented with mild hemoptysis, which progressed to massive hemoptysis six hours after hospitalization, requiring hemodynamic stabilization with blood transfusion. Additional laboratory tests and a chest computed tomography (CT) scan revealed a giant emphysematous bulla. Surgical treatment was performed, consisting of a left anterolateral thoracotomy and left pneumonectomy, which revealed a 3 × 4 cm aspergilloma. The patient was treated with voriconazole and underwent reoperation due to a retained clotted hemothorax on the left side. She was subsequently discharged in stable condition. Conclusion: This is a case of a giant bulla with evidence of an aspergilloma in a young patient.

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References

Aramini, B., Ruggiero, C., Stefani, A., & Morandi, U. (2019). Giant bulla or pneumothorax: How to distinguish. International Journal of Surgery Case Reports, 62, 21–23. https://doi.org/10.1016/j.ijscr.2019.08.003

Barac, A., Kosmidis, C., Alastruey-Izquierdo, A., Salzer, H. J. F., & CPAnet. (2019). Chronic pulmonary aspergillosis update: A year in review. Medical Mycology, 57(Supplement_2), S104–S109. https://doi.org/10.1093/mmy/myy070

Barac, A., Vujovic, A., Drazic, A., Stevanovic, G., Paglietti, B., Lukic, K., Stojanovic, M., & Stjepanovic, M. (2023). Diagnosis of chronic pulmonary aspergillosis: Clinical, radiological or laboratory. Journal of Fungi, 9(11), 1084. https://doi.org/10.3390/jof9111084

Cadena, J., Thompson, G. R., III, & Patterson, T. F. (2021). Aspergillosis: Epidemiology, diagnosis, and treatment. Infectious Disease Clinics of North America, 35(2), 415–434. https://doi.org/10.1016/j.idc.2021.03.008

Campoverde-Espinoza, R. A., Vallejo-López, A. B., & Ramírez-Morán, L. D. (2022). Aspergillus como agente de infecciones respiratorias. MQRInvestigar, 6(4), 771–786. https://doi.org/10.56048/MQR20225.6.4.2022.771-786

Chakraborty, R. K., Gilotra, T. S., Tobin, E. H., & Baradhi, K. M. (2024). Aspergilloma. In StatPearls. StatPearls Publishing.

Crehuet Gramatyka, D., Cortés Sáez, J., Gómez-Chacón Villalba, J., Marco Macián, A., Mínguez Gómez, A., Miró Rubio, I., Costa Roig, A., Del Peral Samaniego, M., & Vila Carbó, J. J. (2020). Tratamiento quirúrgico del aspergiloma pulmonar en pacientes pediátricos. A propósito de tres casos. Cirugía Pediátrica, 33(4), 193–199.

Ferreira Junior, E. G., Costa, P. A., Silveira, L. M. F. G., Almeida, L. E. M., Salvioni, N. C. P., & Loureiro, B. M. (2019). Giant bullous emphysema mistaken for traumatic pneumothorax. International Journal of Surgery Case Reports, 56, 50–54. https://doi.org/10.1016/j.ijscr.2019.02.005

Garvey, S., Faul, J., Cormican, L., Eaton, D., & Judge, E. P. (2022). Symptomatic unilateral idiopathic giant bullous emphysema: A case report. BMC Pulmonary Medicine, 22(1), 341. https://doi.org/10.1186/s12890-022-02135-3

Harmouchi, H., Lakranbi, M., Issoufou, I., Ouadnouni, Y., & Smahi, M. (2019). Pulmonary aspergilloma: Surgical outcome of 79 patients in a Moroccan center. Asian Cardiovascular & Thoracic Annals, 27(6), 476–480. https://doi.org/10.1177/0218492319855492

Hou, X., Zhang, H., Kou, L., Lv, W., Lu, J., & Li, J. (2017). Clinical features and diagnosis of chronic pulmonary aspergillosis in Chinese patients. Medicine, 96(42), e8315. https://doi.org/10.1097/MD.0000000000008315

Lang, M., Lang, A. L., Chauhan, N., & Gill, A. (2020). Non-surgical treatment options for pulmonary aspergilloma. Respiratory Medicine, 164, 105903. https://doi.org/10.1016/j.rmed.2020.105903

Latgé, J. P., & Chamilos, G. (2019). Aspergillus fumigatus and aspergillosis in 2019. Clinical Microbiology Reviews, 33(1), e00140-18. https://doi.org/10.1128/CMR.00140-18

Parums, D. V. (2022). Editorial: The World Health Organization (WHO) fungal priority pathogens list in response to emerging fungal pathogens during the COVID-19 pandemic. Medical Science Monitor, 28, e939088. https://doi.org/10.12659/MSM.939088

Pinto, M., Rodrigues, J., Silva, M., Maia, D., & Miguel, A. (2024). Endobronchial amphotericin B to treat hemoptysis in an inoperable patient with aspergillosis. Medical Mycology Case Reports, 43, 100627. https://doi.org/10.1016/j.mmcr.2024.100627

Siddiqui, N. A., Mansour, M. K., & Nookala, V. (2023). Bullous emphysema. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537243/

Zurita, J., Denning, D. W., Paz-Y-Miño, A., Solís, M. B., & Arias, L. M. (2017). Serious fungal infections in Ecuador. European Journal of Clinical Microbiology & Infectious Diseases, 36(6), 975–981. https://doi.org/10.1007/s10096-017-2928-5