Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Post-operative Aspergillus mediastinitis in a man who was immunocompetent: a case report | Dimopoulos et al. Journal of Medical Case Reports 2010 4 312 http content 4 1 312 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Post-operative Aspergillus mediastinitis in a man who was immunocompetent a case report 1 1 2 3 1 George Dimopoulos Iraklis Tsangaris Garyphalia Poulakou John Panayiotides George Tsaknis Stylianos Orfanos 1 Apostolos Armaganides1 Abstract Introduction Aspergillus spp. infections mainly affect patients who are immunocompromised and are extremely rare in immunocompetent individuals. Case presentation Aspergillus post-operative mediastinitis is considered to be a devastating infection usually affecting patients undergoing cardiothoracic surgery with specific predisposing factors. We describe the case of an immunocompetent 68-year-old Caucasian man with severe chronic thromboembolic pulmonary hypertension who underwent pulmonary thromboendarterectomy and developed post-operative mediastinitis due to Aspergillus flavus. The environmental control did not reveal the source of A. flavus infection and despite combined antifungal therapy our patient died as a result of septic shock and multiple organ failure. Conclusion Aspergillus mediastinitis mainly affects patients after cardiosurgery operations with predisposing factors and it is unusual in patients who are immunocompetent. The identification of the Aspergillus spp. source is often difficult and there are no guidelines for the administration of pre-emptive therapy in this population of at-risk patients. Introduction Aspergillus spp. infections mainly affect patients who are immunocompromised usually being acquired by inhalation of small airborne spores 1 2 . The diagnosis of infection caused by this filamentous fungus poses many difficulties mainly due to the lack of a laboratory method able to discriminate colonization from infection. Not surprisingly the diagnosis is often confirmed by autopsy 1-3 . The difficulty in diagnosis may lead to delayed .
