Pulmonary Phaehyphomycosis in Retroviral Disease Patient

Authors

  • Ummu Afeera Binti Zainulabid Internal medicine, Hospital Tuanku Ampuan Najihah, Malaysia
  • Muhammad Naimmuddin Bin Abdul Azih Internal medicine, Hospital Tuanku Ampuan Najihah, Malaysia
  • Sasi Kumar A/L Maniyam Internal medicine, Hospital Tuanku Ampuan Najihah, Malaysia
  • Azliana Binti Abd Fuaa Department of Pathology and Laboratory Medicine, Kulliyyah of Medicine, International Islamic University of Malaysia
  • Mohd Radhwan Bin Abidin Department of Radiology, Kulliyyah of Medicine, International Islamic University of Malaysia
  • Hajar Fauzan Bin Ahmad Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang

DOI:

https://doi.org/10.31344/ijhhs.v5i0-2.335

Keywords:

Kounis Syndrome, acute coronary syndrome, anaphylactoid reaction, mast cell activation

Abstract

Pulmonary phaeohyphomycosis is a rare infection in the lung caused by black fungi containing a cytoplasmic melanin-like pigment. A 42-year-old man with underlying retroviral disease on HAART was investigated for having constitutional symptoms. Despite undetectable viral load and a high CD4 count, he was found to have unexplained significant loss of weight and appetite over a period of 6 months. Clinical examination revealed a cachexic man with multiple inguinal lymphadenopathies. Excisional biopsy of the inguinal lymph node revealed reactive follicular hyperplasia. CT Thorax, Abdomen and Pelvis was arranged to look for occult malignancy or infection and he was found to have multiple non-enhancing subcentimeter lung nodules mainly at the lateral segment of the right middle lobe of his lung. The largest nodule measured about 0.8 x 1.5 x 0.5 (AP x W x CC), with some nodules having an irregular margin with no extension into the adjacent bronchi. Bronchoscopy was done and demonstrated a black patch at the right intermedius, lateral segment of the middle lobe which did not disappear upon bronchial flush or wash. Histopathological examination found focal areas of blackish pigment and the bronchial alveolar lavage sent for fungal culture grew Cladosporium species. The patient was treated with oral Itraconazole with marked clinical improvement. This case highlights an unusual black fungi infection in the lung that stands out not only for its rarity and it's responsiveness to treatment, but also the susceptibility of an RVD positive patient to this infection despite having suppressed viral load and normal CD4 count.

International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S17

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Published

2021-09-23

How to Cite

Zainulabid, U. A. B., Abdul Azih, M. N. B., A/L Maniyam, S. K., Abd Fuaa, A. B., Bin Abidin, M. R., & Bin Ahmad, H. F. (2021). Pulmonary Phaehyphomycosis in Retroviral Disease Patient. International Journal of Human and Health Sciences (IJHHS), 5(0-2), S17. https://doi.org/10.31344/ijhhs.v5i0-2.335

Issue

2021: Supplementary Issue-2: 2021

Section

Original Articles

License

Copyright (c) 2021 Ummu Afeera Binti Zainulabid, Muhammad Naimmuddin Bin Abdul Azih, Sasi Kumar A/L Maniyam, Azliana Binti Abd. Fuaa, Mohd Radhwan bin Abidin, Hajar Fauzan Bin Ahmad

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