October 28 65 “Doctor Manu” Dr. Manoon Leechwengwong, MD. Respiratory Doctor Wichaiut Hospital Post messages via facebook Mor Manoon Leechawengwong FC to warnlung infectionfrom the breathfungal sporesthat thrivescorn kernels That
A 66-year-old male patient with cough, yellow-green sputum, low-grade fever, fatigue, shortness of breath for 10 days, history of chronic obstructive bronchitis, smoked 2 packs / day, quit smoking for 4 years, ischemic heart disease. He underwent 3 coronary bypass surgeries 4 years ago and took steroid medications for 1 year due to fatigue and difficulty in breathing. The patient has a career in the corn trade. and sale of chemical fertilizers (see photo)
Physical examination, no fever, temperature 37 ° C, auscultation of the lungs with whistling sound, X-ray of the lungs, small white spots in both lungs (see photo) Computer scan of the lungs, multiple diffuse spots in both lungs (see photo) Perform endoscopic procedure in bronchoscopy: in both tracheas there is very thick yellow sputum, which can be sucked up a lot. send water to wash lungs The dye did not detect tuberculosis. Dye found late fungus Fungi were grown as Aspergillus fumigatus and Rhizopus spp. (See figure) Aspergillus galactomannan bronchial antigen was positive.
recap: Pneumonia is caused by a fungal infection. gave a new fungicide Isavuconazole Which is very expensive, can cover both types of mushrooms.After taking the drug, the patient gets better slowly, less cough, less tired.
Patients with low immunity from foodsteroid drugscontinues for a year The patient’s house is next to the corn warehouse, the patient breathes.Fungal spores that grow in corn kernelsin the lungs, the new fungicide must be continued for several months. until the chest X-ray returned to normal.
Source: Mor Manoon Leechawengwong FC
