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SM ISO690:2012 CEBOTARU, Aurelia, BOTNARU, Victor, RUSU, Doina, MUNTEANU, Oxana. Mutilating fungal infection - diagnostic surprise in a patient with post tuberculosis sequelae. In: Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, 21-23 octombrie 2020, Chişinău. Chişinău: USMF, 2020, p. 278. |
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Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” 2020 | |||||
Congresul "Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”" Chişinău, Moldova, 21-23 octombrie 2020 | |||||
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Background. Chronic pulmonary aspergillosis can mimic tuberculosis infection, but at the same time can be an overlapping complication of post-tuberculosis sequelae. Objective of the study. Highlighting the diagnostic difficulties of chronic cavitary pulmonary aspergillosis in a patient cured of disseminated tuberculosis. Material and Methods. A 43-year-old patient, ex-smoker (54 p/y), immunocompetent, diagnosed with disseminated tuberculosis (pulmonary, intestinal, otitis) at the age of 40 (sensitive strain of M. tuberculosis confirmed bacteriologically). Clinical improvement was observed after 12 months of first-line anti-tuberculous drug regimen. For the next 2 years he was monitored annually by chest X-ray and bacteriological exa Results. Relapse of tuberculosis infection was suspected in 2 years after completion of treatment, due to repeated episodes of hemoptysis, cough with purulent sputum (60 ml/day), weight loss of 6 kg during the lats 3 months, fatigue and night sweats. M. tuberculosis infection was excluded by negative molecular and bacteriological tests. Thoracic HRCT identified cylindrical bronchiectasis and a lung cavity with fungus ball in each upper lobe of the both lungs. The serum level of IgG for A.fumigatus within normal limits, no growth of any Aspergillus spp. has been identified by sputum culture. Empirical antifungal therapy with itraconazole resulted in improvement of the symptoms and the absenc Conclusion. The case highlights the diagnostic difficulties of fungal infections in a patient with post tuberculosis sequelae in a country with an increased incidence of tuberculosis infection within settings of limited accessibility to modern diagnostic methods for Aspergillus spp. |
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Cuvinte-cheie Aspergillosis, fungus ball, bronchiectasis, post-tuberculous sequelae, aspergiloză, micetom, Bronşiectazii, sechele posttuberculoase |
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