The invisible enemy always present

Posted on 4 June, 20234 June, 2023 by Foro Osler

An enemy runs through the inpatient wards in Medical Oncology and Haematology. This enemy can be in the environment, where patients are admitted, especially in people who are immunosuppressed and on prolonged steroid treatment.

This enemy is a fungus, aspergillus, very ubiquitous in the environment. The infection can be disseminated in the lung or can be a single lesion called “Aspergilloma”, like the one that we showed here.

The basis for a diagnosis is clinical suspicion in patients with prolonged steroid treatment and immunosuppression. Diagnosis of this process is, sometimes, difficult and often requires invasive measures such as a bronchoscopy. Early diagnosis is very important because it can spread and has a high mortality rate. The main symptoms are usually a productive cough and hemoptysis.

Two tests are used to aid in diagnosis, the Beta-D-glucan method, and the detection of Galactomannan antigen in serum and bronchoaspirate material. Hyphae of the fungus can be observed in the biopsy material.