Acute Aspergillus pneumonia associated with mouldy tree bark-chippings, complicated by anti-glomerular basement membrane disease causing permanent renal failure

Abstract

A non-immunocompromised man developed acute Aspergillus pneumonia after spreading mouldy tree bark mulch. Despite normal renal function at presentation, he developed rapidly progressive glomerulonephritis with acute kidney injury due to anti-glomerular basement membrane antibodies (anti-GBM) 4 weeks later. He remained dialysis dependent and died of sepsis 10 months later. We hypothesise that he contracted invasive pulmonary Aspergillosis from heavy exposure to fungal spores, leading to epitope exposure in the alveoli with subsequent development of GBM auto-antibodies.

First record of C.cerealis from Camel meat lesions in Egypt.

“…Fungal infection could be increased in animals exposed to long term antibacterial treatment and immunosuppression (Pfaller et al, 2006). However, at risk for fungal infection include also normal individual as cases of invasive aspergillosis have been reported in normal hosts after extensive environmental exposure to Aspergillus spores in the form of tree-bark chippings (Butler et al, 2013), or after inhalation of a great deal of dust in a mushroom factory (Shimaoka et al, 2006). Considering the desert nature of the sampling area and the continuous windy environment beside the severe cold condition that camel are exposed in winter in the North of Egypt in the current study may explain the chance of getting fungal infection in some weak camel that are not sheltered all the time.…”

Coinfection with Lichtheimia corymbifera and Aspergillus flavus in an Immune-Competent Patient Mimicking as Pulmonary-Renal Syndrome

“…Invasive pulmonary mycosis has been rarely reported in patients with no apparent risk factors [10][11][12][13][14][15][16]. In most instances, extensive environmental exposure to fungal spores during occupational or recreational activities has been identified as an initiating event.…”

Chronic Cough and Bilateral Pulmonary Infiltrates in a Previously Healthy Adolescent Male

“…Invasive pulmonary aspergillosis is very uncommon in immunocompetent hosts but has been reported after near drowning, or large exposures to mulch while gardening. 3-5 Patients with CGD can present with an acute fulminant IPA following mulch exposure. 6 In our patient, immunodeficiency disorders, including CGD were excluded.…”