We report a case of a 65-year-old female diagnosed with sever dengue fever. She started showing recovery from dengue fever with medical management. On day 6 of admission, she had leukocytosis, altered mental sensorium, and hemoptysis. Chest tomography showed air space consolidation with multiple nodules in the left upper and middle lobe sputum and bronchoalveolar lavage cultures were positive for Aspergillus flavus. The patient showed improvement with voriconazole and therapy was continued for 6 weeks.
Comprehensive Guidelines for Prevention and Control of Dengue Fever and Dengue Haemorrhagic Fever. World Health Organization, 2011. Available from: http://www.who.int/csr/disease/dengue/en/. Last Accessed on 2013 05.
Kousha M, Tadi R, Soubani AO. Pulmonary aspergillosis: A clinical review. Eur Respir Rev 2011;20:156-74.
Meersseman W, Vandecasteele SJ, Wilmer A, Verbeken E, Peetermans WE, Van Wijngaerden E. Invasive aspergillosis in critically ill patients without malignancy. Am J Respir Crit Care Med 2004;170:621-5.
Vandewoude KH, Blot SI, Depuydt P, Benoit D, Temmerman W, Colardyn F, et al. Clinical relevance of Aspergillus isolation from respiratory tract samples in critically ill patients. Crit Care 2006;10:R31.
Vehreschild JJ, Bröckelmann PJ, Bangard C, Verheyen J, Vehreschild MJ, Michels G, et al. Pandemic 2009 influenza A (H1N1) virus infection coinciding with invasive pulmonary aspergillosis in neutropenic patients. Epidemiol Infect 2012;140:1848-52.
Ohnishi T, Andou K, Kusumoto S, Sugiyama H, Hosaka T, Ishida H, et al. Two cases of successfully treated invasive pulmonary aspergillosis following influenza virus infection. Nihon Kokyuki Gakkai Zasshi 2007;45:349-55.
Ruhnke M, Böhme A, Buchheidt D, Donhuijsen K, Einsele H, Enzensberger R, et al. Diagnosis of invasive fungal infections in hematology and oncology - Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 2003;82 Suppl 2:S141-8.
Garnacho-Montero J, Amaya-Villar R. A validated clinical approach for the management of aspergillosis in critically ill patients: Ready, steady, go! Crit Care 2006;10:132.