Gardening can induce pulmonary failure: Aspergillus ARDS in an immunocompetent patient, a case report

作者：Jung Nina^*; Mronga Silke; Schroth Susanne; Vassiliou Timon; Sommer Frank; Walthers Eduard; Aepinus Christian; Jerrentrup Andreas; Vogelmeier Claus; Holland Angelique; Koczulla Rembert

来源：BMC Infectious Diseases, 2014, 14(1): 600.

DOI：10.1186/s12879-014-0600-6

• Aspergillus fumigatus
• Sepsis
• ECMO
• Immunocompetent patient
• Treatment

Background: Acute Aspergillus fumigatus infection in immunocompetent patients is rare. This is the first known case of a patient who survived Aspergillus sepsis after being treated early with veno-venous extracorporeal membrane (ECMO) and antifungal therapy. %26lt;br%26gt;Case presentation: An immunocompetent 54-year-old woman was exposed to plant mulch during gardening and subsequently developed pulmonary failure that progressed to sepsis with multiorgan failure. Owing to her severe clinical condition, she was treated for acute respiratory distress syndrome (ARDS) with veno-venous ECMO. Empiric antifungal therapy comprising voriconazole was also initiated owing to her history and a previous case report of aspergillosis after plant mulch exposure, though there was no microbiological proof at the time. A. fumigatus was later cultured and detected on antibody testing. The patient recovered, and ECMO was discontinued 1 week later. After 7 days of antifungal treatment, Aspergillus antibodies were undetectable. %26lt;br%26gt;Conclusions: In cases of sepsis that occur after gardening, clinicians should consider Aspergillus inhalation as an aetiology, and early antimycotic therapy is recommended.

• 出版日期2014-11-26
• 单位河北医科大学