Summary
A case of apparently primary lymph node granulomatous aspergillosis is described. A review of the so-called primary aspergillosis cases since 1977 shows that granulomatous instead of exudative inflammation patterns have been observed in histological sections only when neither major nor minor predisposing factors have been detected in the clinical history of the patients. A possible pathogenetic role of selectively impaired cell-mediated immune response in these cases is hypothesized. Flucytosine treatment is indicated in a few selected cases of deep aspergillosis.
Zusammenfassung
Ein Fall von offensichtlich primärer granulomatöser Aspergillose der Lymphknoten wird beschrieben. Eine retrospektive Analyse der Fälle von sogenannter primärer Aspergillose, beginnend im Jahr 1977, zeigt, daß in den histologischen Schnitten vor allem granulomatöse anstelle von exsudativen Infiltraten beobachtet werden konnten. Dieses trifft besonders dann zu, wenn weder bedeutende noch geringfügige prädisponierende Faktoren in der Anamnese der Patienten entdeckt werden konnten. Eine mögliche pathogenetische Rolle wird in diesen Fällen der selektiven Beeinträchtigung der zellvermittelten Immunantwort zugesprochen. Die Behandlung mit Flucytosin ist in wenigen ausgewählten Fällen von tiefer Aspergillose indiziert.
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Mazzoni, A., Nanetti, A., Manfredi, R. et al. Primary lymph node invasive aspergillosis. Infection 24, 37–42 (1996). https://doi.org/10.1007/BF01780649
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DOI: https://doi.org/10.1007/BF01780649