Necrotizing pulmonary aspergillosis caused by anorexic syndrome — a case report

Abstract

<jats:title>Abstract</jats:title><jats:p>The patient presented is a 44-year-old female treated for cavitary changes in the lung apexes. Due to suspected tuberculosis, treatment began with anti-tuberculosis (AT) drugs, despite negative sputum smears for acid-fast bacilli. During hospitalization, the patient was febrile (up to 38°C), hypotensive, extremely cachectic (32 kg), had a dry cough, increased nitrogen products, hypokalemia and anemia. Because of poor response to the applied AT therapy, bronchoscopic tests were repeated and spores of aspergillus fungus were discovered in the pathohistological findings of transbronchial lung biopsy. The appropriate treatment with amphotericin B and voriconazole was initiated. A psychiatric opinion was requested because we suspected that the patient suffered from the anorexic syndrome (anorexia nervosa). This diagnosis was confirmed by a psychiatrist; her psychiatric treatment began simultaneously with the treatment in our facility. Anorexia was the cause of the cachexia, immunodeficiency and invasive pulmonary aspergillosis. The disorder was not recognized before the manifestation of the somatic disorder. There is little data in the available literature on the association between these two diseases.</jats:p>

Systemic Immune Response Against Bacterial Infections in Pneumonia Patients at Babylon province

“…Sputum specimens were collected aseptically from 118 patients, with proof pneumonia as clinically diagnosed by physicians, who were admitted to Medical Marjan City and to General Al-Hashemyia Hospital in Babylon province during a period extended from January till December 2015. All specimens divided into two groups male (n=36) and female (n=27) each group subdivided into four groups according to the age [ (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46),(47-62),(63 ≤ )] male and female in sequence. The following data were recorded for each patient: age, sex, hospitalization.…”

“…However, the recorded rates for mixed infection differ in the range of 2.5-38% According to age, the occurrence of pneumonia increased in patients aged range between 47-62 years. Decreasing pulmonary functions, due to their age related to the physiological and immunological changes and other comorbidities, as aging process advances may explain this fact [26] . In respect to sex, our results (Table 4) showed consistency with study [27] that recorded occurrence of pneumonia in the males and females were (60.4%) and (39.6%) respectively, which may probably due to cigarette smoking was more common among male [28] .…”