Acute tracheobronchitis caused by <i>Aspergillus</i>: case
               report and imaging findings

Acute tracheobronchitis is a rare manifestation of invasive aspergillosis, generally occurring in severely immunocompromised patients. The authors report the case of a patient presenting with this condition after bone-marrow transplantation, with emphasis on tomographic findings.

Aspergillosis; Tracheal disease; Immunocompromised host

Authorship

Katia Hidemi Nishiyama Mailing Address: Dra. Katia Hidemi Nishiyama. Rua Tamandaré, 776, ap.132, Liberdade. São Paulo, SP, Brazil, 01525-000. E-mail: katianishiyama@yahoo.com.br

MD, Researcher, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilMD, Researcher, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Esther de Alencar Aripe Falcão

MD, Resident, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilMD, Resident, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Fernando Uliana Kay

MDs, Physician Assistants, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilMDs, Physician Assistants, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Gustavo Borges Silva Teles

Fabiola Del Carlo Bernardi

PhD, Physicians Assistant, Department of Pathology - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilPhD, Physicians Assistant, Department of Pathology - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Marcelo Buarque de Gusmão Funari

PhD, MD, Radiologist, Head of Unit of Thoracic Radiology, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilPhD, MD, Radiologist, Head of Unit of Thoracic Radiology, Radiology Department - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Mailing Address: Dra. Katia Hidemi Nishiyama. Rua Tamandaré, 776, ap.132, Liberdade. São Paulo, SP, Brazil, 01525-000. E-mail: katianishiyama@yahoo.com.br

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (3)

Thumbnail

Figure 1
Non contrast-enhanced chest CT, axial sections. a: Mediastinal window – subtle tracheal thickening (arrow) associated with slight densification of the adjacent mediastinal fat. b: Mediastinal window – also, observe the presence of parietal thickening of the main bronchi, most noticeable at left (arrow). c: Lung window – bronchial wall thickening (arrow) associated with laminar atelectasis (arrowhead).

Thumbnail

Figure 2
Non contrast-enhanced chest CT, axial sections performed one month and ten days following the first CT scan. a,b: Mediastinal wall – there was increase in the diffuse thickening of the tracheal and bronchial walls (arrows), particularly at left, and greater blurring of the adjacent mediastinal fat. c: Lung window – increase in the bronchial wall thickening and pulmonary atelectasis in the left lower lobe (arrowhead), with development of adjacent centrilobular micronodules.

Thumbnail

Figure 3
Anatomopathological analysis and chest CT, four weeks after the first CT scan. a,b: Fungal structures with bifurcation at 45°. b: Fungi-specific Grocott staining. c: Non contrast-enhanced chest CT, axial section, four weeks after the first CT scan reveals disease progression with increased tracheobronchial thickening (arrow), as well as increased densification of the mediastinal fat.

Figure 1 Non contrast-enhanced chest CT, axial sections. a: Mediastinal window – subtle tracheal thickening (arrow) associated with slight densification of the adjacent mediastinal fat. b: Mediastinal window – also, observe the presence of parietal thickening of the main bronchi, most noticeable at left (arrow). c: Lung window – bronchial wall thickening (arrow) associated with laminar atelectasis (arrowhead).

Figure 2 Non contrast-enhanced chest CT, axial sections performed one month and ten days following the first CT scan. a,b: Mediastinal wall – there was increase in the diffuse thickening of the tracheal and bronchial walls (arrows), particularly at left, and greater blurring of the adjacent mediastinal fat. c: Lung window – increase in the bronchial wall thickening and pulmonary atelectasis in the left lower lobe (arrowhead), with development of adjacent centrilobular micronodules.

Figure 3 Anatomopathological analysis and chest CT, four weeks after the first CT scan. a,b: Fungal structures with bifurcation at 45°. b: Fungi-specific Grocott staining. c: Non contrast-enhanced chest CT, axial section, four weeks after the first CT scan reveals disease progression with increased tracheobronchial thickening (arrow), as well as increased densification of the mediastinal fat.

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