Aspergillary bronchopneumonia: an unusual cause of atelectasis and asphyxia in a leukemic patient

a 22-year-old man in his first relapse of t-acute lymphoblastic leukemia developed fever and a pulmonary infiltrate after 23 days of granulocytopenia. although having been under amphotericin b for 10 days, productive purulent cough ensued, with right lobe atelectasis and acute ventilatory failure that resolved after the elimination of a thick gelatinous bronchial plug. sputum cultures yielded candida albicans and staphylococcus epidermidis, and microscopic examination of the sputum plug disclosed aspergillus hyphae. the patient died 9 days after, of a disseminated aspergillus infection, confirmed by necropsy.