Services on Demand
Journal
Article
Indicators
- Cited by SciELO
- Access statistics
Related links
- Similars in SciELO
Share
Revista de la Facultad de Medicina (México)
On-line version ISSN 2448-4865Print version ISSN 0026-1742
Abstract
SALAZAR MORALES, Miguel Fernando and RECINOS CARRERA, Elio Germán. Disseminated aspergillosis: postmortem findings in a case of maternal sepsis. Rev. Fac. Med. (Méx.) [online]. 2013, vol.56, n.6, pp.24-32. ISSN 2448-4865.
We describe autopsy findings in a case of maternal death caused by invasive aspergillosis in its disseminated form. Case: 20 year old female with previous medical history of preeclampsia who started with malaise, pelvic pain and fever during her second pregnancy. A fetal obitus was obtained after labor although she remained with uterine hypotony and hemodynamic unsteadiness. She was referred to a general hospital subsisting with fever, acute pelvic sepsis, deteriorated ventilatory function, cerebral lesions visualized by tomography, gastrointestinal bleeding, oliguria and systemic inflammatory response with bilateral acral lower extremities necrosis. She died ten days after her arrival and autopsy was authorized. Results: Necropsy uncovered lungs with consolidated areas and extensive haemorrhage, valvular and mural heart vegetations and numerous cerebral lesions with infarct-like appeareance. Light microscopy revealed the presence of septate hyphae with regular acute angle branching invading lung microvasculature, endocardial surface, myocardium, Virchow-Robin space and neuropil. The hyphae were also identified in thyroid, trachea, gastric mucosa and kidney histological sections. Conclusion: Disseminated aspergillosis is a high-mortality infectious process that usually affects immunocompromised patients, specially those coursing with neutropenia. Despite immunological changes experienced as part of normal pregnancy, these per se do not predispose the mother to infections caused by opportunistic pathogens.
Keywords : Aspergillus spp; invasive pulmonary aspergillosis; disseminated aspergillosis; immunology of pregnancy; inflammation during pregnancy.