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Invasive aspergillosis masquerading as catastrophic antiphospholipid syndrome.

Abstract
A 25-year-old woman with a history of systemic lupus erythematosus who was taking steroids came to the hospital because of vague signs and symptoms of weight loss, constipation, and oral ulcers. Multiorgan dysfunction developed, and catastrophic antiphospholipid syndrome was suspected. She was treated with an intravenous infusion of heparin, but she experienced a subdural hemorrhage and died on day 10 of the hospitalization. An autopsy revealed disseminated invasive aspergillosis. This case illustrates that invasive aspergillosis is a frequently missed diagnosis and should be part of the differential diagnosis for any patient who is immunosuppressed, including patients with autoimmune diseases such as systemic lupus erythematosus.
AuthorsKathryn S Robinett, Bethany Weiler, Avelino C Verceles
JournalAmerican journal of critical care : an official publication, American Association of Critical-Care Nurses (Am J Crit Care) Vol. 22 Issue 5 Pg. 448-51 (Sep 2013) ISSN: 1937-710X [Electronic] United States
PMID23996427 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural)
Topics
  • Adult
  • Antiphospholipid Syndrome (diagnosis)
  • Aspergillosis (diagnosis)
  • Aspergillus fumigatus (isolation & purification)
  • Diagnosis, Differential
  • Fatal Outcome
  • Female
  • Humans
  • Lung (pathology)
  • Lung Diseases, Fungal (diagnosis)
  • Lupus Erythematosus, Systemic (complications)
  • Multiple Organ Failure (etiology)

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