Invasive Pulmonary Aspergillosis Occluding the Descending Aorta and Left Pulmonary Artery

Abstract

Invasive pulmonary aspergillosis (IPA) has been recognized as an infectious complication in immunocompromised patients. We present a case of IPA, which occluded the descending aorta and left pulmonary artery and led to death after antileukemic chemotherapy. Contrast-enhanced CT demonstrated thrombi in the great vessels as low attenuation areas. These thrombi became extensive despite intensive antibiotic and antifungal therapy. Microscopic examination revealed that the thrombi contained aspergillus hyphae, and occlusions of both great vessels were induced by direct extension of aspergillus. This case illustrates that IPA can be the cause of great vessel occlusion in immunocompromised patients. We describe the CT and autopsy findings of this case and emphasize the virulence of this fungus.