Background
Aspergillus is a ubiquitous fungus responsible for allergic as well as saprophytic and invasive manifestations depending on host’s immune status. The following case report demonstrates progression of allergic manifestations of Aspergillus to its invasive form in an individual with decreasing immunity. This can lead to uncertainties in diagnosis and management.Case presentationA 28-year-old male, non smoker, known case of ABPA (allergic bronchopulmonary aspergillosis) was admitted with complaints of cough for 1 month, associated with recurrent episodes of hemoptysis for last 5 days. CT Thorax revealed homogenous dense round opacity in right upper lobe which replaced previous fibrocalcific bronchiectatic lesion with cavity and aspergilloma, bulging across the major fissure with fibrotic strands extending to periphery in all directions. Post-pneumonectomy microscopic examination revealed Aspergillus hyphae invading blood vessels.ConclusionThere is a need for close clinical and radiologic follow up of patients with Aspergillus and our patient demonstrated overlap of complete spectrum of Aspergillus disease with march from one end to the other end.
Although hemangiomas are common in infancy and childhood, they are probably developmental abnormalities rather than true neoplasms. In present case we have treated a child aged 10 years with haemangioma of the right side of the Neck. After thorough investigation we posted this for intralesional infiltration of Sclerosing agent (Inj. Polidocanol 3%) in 1:3 dilution with normal saline. Approximately 2 ml Inj. Polidocanol diluted with saline was injected into the lesion. And the same procedure was repeated in three sittings after one week interval. The size and vascularity was reduced dramatically after single procedure. Patient was followed up after one and two months interval. There was no sign of any recurrence. This Procedure was chosen as it is cosmetically more acceptable, can be used for the haemangiomas at inaccessible areas where surgery is difficult, day care procedure and cost effective. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 56-59 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6828
Uncontrolled diabetes is a known immunosuppressive state. It predisposes individuals to bacterial and fungal infections. The present case report demonstrates sequential infections by Klebsiella followed by tuberculosis and later development of mucormycosis in a poorly controlled diabetic patient. Timing of diagnosis is of essence because of high mortality seen with such pulmonary infections. High index of suspicion needs to be maintained as the same individual may harbor multiple infections as highlighted in this case.
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