BMJ Case Reports 2014; doi:10.1136/bcr-2014-203764

Invasive pulmonary aspergillosis in a patient presenting with idiopathic systemic capillary leak syndrome

  1. Tadashi Mio1
  1. 1Department of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto-shi, Kyoto, Japan
  2. 2Department of Emergency and Critical Care Medicine, National Hospital Organization Kyoto Medical Center, Kyoto-shi, Kyoto, Japan
  1. Correspondence to Dr Manabu Hayama, hayama-nar{at}
  • Accepted 3 May 2014
  • Published 23 May 2014


A 54-year-old man presented to our emergency department with fever and dyspnoea. He required vigorous haemodynamic support and mechanical ventilation for hypotensive distributive shock with hypoalbuminaemia, haemoconcentration, rhabdomyolysis and acute renal failure, consistent with idiopathic systemic capillary leak syndrome. Left lung consolidation and hypoxaemia were observed 6 days after admission. Sputum smear revealed the presence of acute angled branching hyphae, consistent with a diagnosis of invasive pulmonary aspergillosis. Antifungal therapy was administered and mechanical ventilation discontinued on day 66. The patient recovered and was discharged from the hospital on day 185.

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