A female in her late 20s presented to her PCP with congestion, headaches, dry cough, some dizziness and gum pain after returning from a trip to Asia. She was initially diagnosed with a viral URI.
With no improvement of her symptoms, she was later diagnosed with sinusitis- because of the congestion and pain. She was prescribed amoxicillin but with no improvement, was switched to azithromycin. Since her shortness of breath became worse, she saw her primary care physician again and was switched to moxifloxacin.
Chest CT showed a focal left hilar opacity, approximately 3.5 x 3 cm. The etiology of the left hilar mass was not clear. The differential diagnosis would most likely include infectious causes.
Bacterial pneumonia? Maybe, but Patient has been on antibiotics with no remission.
Fungal pneumonia? Patient is not immunocompromised, so less likely.
Lung Cancer? Possible, but the patient is young.
It was decided to proceed with bronchoscopy with lavage and possible biopsies, if needed.
Aspergillus fumigatus DNA detected in BAL by Aspergillus PCR.
Please refer to Available Tests for more information about ASPPCR.