Bronchoalveolar lavage: Invasive Aspergillosis


Drs. Prolla and Diehl's INTERESTING CASE OF THE MONTH March 2003 Case B
 

Invasive Aspergillosis, 200x M-G-G staining, faintly stained dychotomous branching hyphae

Invasive Aspergillosis, 200x M-G-G staining, faintly stained hyphae

Invasive Aspergillosis, 500x M-G-G, faintly stained hyphae

Invasive Aspergillosis, 500x KOH direct smear, hyaline septate hyphaeKOH 10% smear

500x KOH direct smear, hyaline septate hyphaeKOH 10% smear

Invasive Aspergillosis, 100x Gomori, large number of hyphae

Invasive Aspergillosis, 100x Gomori, large number of hyphae

Invasive Aspergillosis, 500x Gomori, 45 degree dychotomous branching large hyphae

Invasive Aspergillosis, 500x Gomori, 45 degree branching large hyphae


The M-G-G stained smears show some faintly stained hyphae, irregularly branching, in a necrotic background. This, and the clinical presentation suggest either Aspergillosis or Zygomycosis. The Gomori staining shows 45-degree branching dychotomous hyphae, highly suggestive of Aspergillus. The KOH 10% direct smears show large hyaline septate hyphae, also highly suggestive of Aspergillus sp. In contrast, Rhyzopus and other Mucorales, have random right-angled branching, and almost no septa in their hyphae.
Cultures confirmed the diagnosis of Aspergillus fumigatus.




Case A March 2003 References
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