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Case ReportCase Reports

Disseminated Aspergillosis Associated With Tsunami Lung

Yutaka Kawakami, Takashi Tagami, Takashi Kusakabe, Norihiro Kido, Takanori Kawaguchi, Mariko Omura and Ryoichi Tosa
Respiratory Care October 2012, 57 (10) 1674-1678; DOI: https://doi.org/10.4187/respcare.01701
Yutaka Kawakami
Department of Emergency and Critical Care Medicine; and
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Takashi Tagami
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
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  • For correspondence: [email protected]
Takashi Kusakabe
Department of Pathology, Aidu Chuo Hospital, Fukushima, Japan.
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Norihiro Kido
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
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Takanori Kawaguchi
Department of Pathology, Aidu Chuo Hospital, Fukushima, Japan.
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Mariko Omura
Department of Emergency and Critical Care Medicine; and
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Ryoichi Tosa
Department of Emergency and Critical Care Medicine; and
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  • Fig. 1.
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    Fig. 1.

    The chest radiograph (left) showing bilateral diffuse infiltration in all lung zones on admission. The computed tomography scan (right) showing moderate atelectasis in the bilateral inferior lobe.

  • Fig. 2.
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    Fig. 2.

    Serial chest radiograph showing a rounded opacity in the right lower zone on day 6, which gradually increased in size (day 11), with additional involvement of the right upper zone, giving an appearance of a fungus ball (day 14) in the lower zone, and finally involving the bilateral lung fields on day 18.

  • Fig. 3.
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    Fig. 3.

    Grossly, the lung shows multiple cavitary lesions, which on microscopy showed necrotizing pneumonia, with colonization of the cavities and acutely branching Aspergillus hyphae. There is invasion of the blood vessels and parenchyma (right × 200, hematoxylin and eosin stain). Grocott staining shows dichotomously branching and septate hyphae (inset × 400).

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    Fig. 4.

    Gross specimen of the heart shows several abscesses (arrows) in the left ventricle (left). Aspergillus hyphae can be seen growing in the abscess cavity, with extensive myocardial destruction and neutrophilic infiltration (right × 200, hematoxylin and eosin stain).

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Respiratory Care: 57 (10)
Respiratory Care
Vol. 57, Issue 10
1 Oct 2012
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Disseminated Aspergillosis Associated With Tsunami Lung
Yutaka Kawakami, Takashi Tagami, Takashi Kusakabe, Norihiro Kido, Takanori Kawaguchi, Mariko Omura, Ryoichi Tosa
Respiratory Care Oct 2012, 57 (10) 1674-1678; DOI: 10.4187/respcare.01701

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Disseminated Aspergillosis Associated With Tsunami Lung
Yutaka Kawakami, Takashi Tagami, Takashi Kusakabe, Norihiro Kido, Takanori Kawaguchi, Mariko Omura, Ryoichi Tosa
Respiratory Care Oct 2012, 57 (10) 1674-1678; DOI: 10.4187/respcare.01701
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Keywords

  • ARDS
  • autopsy
  • cardiomyopathy
  • disasters
  • disseminated aspergillosis
  • extravascular lung water

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