PMC4629432_01
The left chest-X-ray revealed alveolar infiltration in the right lower lobe before diagnosis.
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F1
Due to progressive symptoms and significant weight loss as well as chest imaging findings (Figure 1), bronchoscopy was performed without remarkable findings.
Chest CT revealed alveolar consolidation and adjacent ground glass opacity in the right lower lobe.
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F2
Based on his progressive condition and negative investigations (Figure 2), CT-guided biopsy of the lung lesion was performed, which revealed alveolated lung parenchyma with interstitial thickening due to infiltration of lymphoplasma cells as well as some eosinophils and a few ill-defined hyaline septate hyphae.
Lung biopsy revealed alveolated lung parenchyma with interstitial thickening due to infiltration of lymphoplasma cells and a few eosinophils.
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F3
The conidia were elongated and arranged in loose clusters in a crisscross formation at the tip of a long, slender, delicate conidiophore (Figures 3 and 4).
Microscopic view of Acremonium hypha and conidia; direct smear of the isolated organism from the culture medium
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F4
The conidia were elongated and arranged in loose clusters in a crisscross formation at the tip of a long, slender, delicate conidiophore (Figures 3 and 4).
Chest-X-ray 8 weeks after treatment with itraconazole.
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F5
Itraconazole 200 mg twice daily was initiated and within a week, respiratory symptoms ameliorated and after a couple of weeks he was symptom-free and chest-X-ray was completely normal (Figure 5).