DIAGNOSTIC AND MANAGEMENT PROBLEMS IN PULMONARY ASPERGILLOSIS

Abstract

TYPE: Late Breaking Abstract TOPIC: Chest Infections INTRODUCTION: The gold standard for the definite diagnosis of opportunistic infections in the respiratory system is represented by the bronchial biopsy accompanied by the histopathological examination, thus eliminating the suspicion of other diseases at this level. CASE PRESENTATION: In January of this year, a 59-year-old patient presented to the pulmonology department, accusing the sensation of suffocation in supine position, accentuated during the evening, retrosternal embarrassment and epigastric pain. From the patient’s history we remember SARS-COV2 infection, sarcoidosis and cardiac pathology, with outpatient backgroung treatment. The objective examination shows pale, cold skin, sound chest, no bronchial rales. From laboratory data we note slight inflammation, mild neutropenia and anemia. Functional respiratory tests are normal. The sputum examination doesn’t show the pathogenic flora, the Galactomannan antigen is negative. Thus, fibrobronchoscopy with biopsy is performed, the cytohistological result highlighting septate hyphae with sharp-angled branches, conidia and metules of the genus Aspergillus Spp. The evolution during the hospitalization period is favorable under the antibiotic and symptomatic treatment, subsequently following the outpatient antifungal treatment. DISCUSSION: We are facing a case in which establishing an early diagnosis of pulmonary aspergillosis is a challenge, being known that a proper therapy can prevent further complications. CONCLUSIONS: Patients with pre-existing lung disease may contract various infections and the response of the immune system depends on the degree of damage. DISCLOSURE: No significant relationships. KEYWORD: pulmonary aspergillosis