VOLUME 35 | ISSUE 5 | SEPTEMBER-OCTOBER 2015

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Invasive pulmonary aspergillosis presenting as thoracic mass causing obstruction of the superior and inferior vena cava in an immunocompetent patient: a diagnostic dilemma

Moti Lal Bunkar,a Rajendra Prasad Takhar,a Savita Aryab

From the aDepartment of Respiratory Medicine and bDepartment of Dermatology, Government Medical College, Rajasthan, India

How to cite this article:

Bunkar ML, Takhar RP, Arya S. Invasive pulmonary aspergillosis presenting as thoracic mass causing obstruction of the superior and inferior vena cava in an immunocompetent patient: a diagnostic dilemma. Ann Saudi Med 2015; 35(5): 409-413.

Abstract

 

 

Invasive pulmonary aspergillosis (IPA) is a disease of immunocompromised patients, but its prevalence is increasing in immunocompetent persons. Patients usually present with non-specific symptoms, sometimes consistent with bronchopneumonia. We discuss the case of a 19-year-old boy who presented with constitutional respiratory symptoms along with signs of obstruction of the superior and inferior vena cava. A chest radiograph was suggestive of a thoracic mass raising suspicion of bronchogenic carcinoma/ benign mass, sarcoidosis and tuberculosis, but a diagnosis of invasive aspergillosis was established. The patient showed excellent clinico-radiological improvement with administration of voriconazole. Invasive pulmonary aspergillosis may also present with atypical findings and should be considered in differentials when investigating a case even if the patient does not have a risk factor. 

 

 

 

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