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Ann Thorac Surg 2009;88:1352-1354. doi:10.1016/j.athoracsur.2009.02.087
© 2009 The Society of Thoracic Surgeons
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Anthony W. Kim
William H. Warren
Michael J. Liptay
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Right arrow Mediastinum

Case Reports

An Unusual Case of Aspergillus Fibrosing Mediastinitis

Sean C. Wightman, BAa, Anthony W. Kim, MDa, Laurie A. Proia, MDb, L. Penfield Faber, MDa, Paolo Gattuso, MDc, William H. Warren, MDa, Michael J. Liptay, MDa,*

a Division of Thoracic Surgery, Rush University Medical Center, Chicago, Illinois
b Section of Infectious Disease, Rush University Medical Center, Chicago, Illinois
c Department of Pathology, Rush University Medical Center, Chicago, Illinois

Accepted for publication February 20, 2009.

* Address correspondence to Dr Liptay, Division of Thoracic Surgery, Rush University, 1725 West Harrison St, Suite 774, Chicago, IL 60612 (Email: michael_liptay{at}rush.edu).

Fibrosing mediastinitis due to Aspergillus is rare, particularly in the immunocompetent host. Fibrosing mediastinitis due to Aspergillus species in the immunocompetent patient can be indolent and may be treated with antifungal therapy rather than surgery. We present a 78-year-old nonsmoking, nondiabetic woman with chronic fibrosing mediastinitis due to Aspergillus. Multiple attempts at securing a tissue diagnosis were inconclusive. Ultimately, Aspergillus infection was diagnosed by a video-assisted thoracoscopic surgical biopsy. The patient was started on oral voriconazole, and she remains clinically stable with radiographic improvement. A prolonged, perhaps lifelong, course of antifungal therapy is planned.






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