RESPIRATORY-DISTRESS DUE TO TRACHEAL ASPERGILLOSIS IN A SEVERELY IMMUNOCOMPROMISED PATIENT

A 23-year-old man, intensively treated for acute lymphoblastic leukaem ia in relapse and with documented pulmonary aspergillosis, was admitte d to the intensive care unit for acute respiratory failure. The diagno sis of invasive tracheal aspergillosis was made by bronchoscopy and bi opsy. The lesions consisted of extensive necrotizing bronchitis with t ransmural and peribronchial extension associated with tracheal and bro nchial obstruction due to the presence of pseudomembranes almost entir ely composed of fungal hyphae. Despite treatment with amphotericin B a nd itraconazole, mechanical ventilation and bronchoscopy, the patient died 3 weeks later of massive bleeding.