
PW MedEd
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A 40 year old male was brought to the trauma center after a road traffic accident. During the primary survey, his vitals were unstable. The breath sounds were absent on the right side and neck veins were distended. A plain chest xray was acquired as shown below. What is the likely diagnosis?


*Solutions* β In invasive aspergillosis, Aspergillus forms fruiting bodies (usually in lung cavities) and septate filaments, 5 to 10 ΞΌm thick, branching at acute angles (40 degrees). Aspergillus is a ubiquitous mold that causes allergies (allergic bronchopulmonary aspergillosis) in otherwise healthy people and serious sinusitis, pneumonia, and invasive disease in immunocompromised individuals.

A 68-year-old with a history of poorly controlled type 2 diabetes mellitus, presented with features of pneumonia. Imaging showed cavitary lesions in both lungs. Sputum TB-PCR was negative. Lung biopsy from the cavitary lesion was done following inadequate response to empirical antibiotic therapy. Histopathology is shown in the diagram (PAS stain). Identify the causative organism?


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