LETTER TO EDITOR |
https://doi.org/10.4103/ijrc.ijrc_9_19 |
Pleuropulmonary Aspergillosis Presenting as Hydropneumothorax in Second Trimester Pregnancy
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
E-mail: mdalmendalawi@yahoo.com
How to cite this article: Al-Mendalawi MD. Pleuropulmonary aspergillosis presenting as hydropneumothorax in second trimester pregnancy. Indian J Respir Care 2019;8:136.
© 2019 Indian Journal of Respiratory Care | Published by Wolters Kluwer - Medknow
Sir,
I read with great interest the case report by Chinnasamy et al.[1] published in January-June 2019 issue of the Indian Journal of Respiratory Care. The authors reported a case of pleuropulmonary aspergillosis (PPA) presenting as hydropneumothorax in a 29-year-old Indian pregnant woman with 16 weeks of gestation. In the light of the absent prior pulmonary pathology, a major risk factor for PPA, I assume that defective immune status ought to be considered in the studied patient. Among conditions associated with defective immunity, infection with human immunodeficiency virus (HIV) has the leading priority. It is explicit that due to low immunity, individuals infected with HIV are at increased risk to various bacterial, viral, fungal, and protozoal infections. Among fungal infections, pulmonary aspergillosis has been reported in HIV-positive individuals.[2–4] In India, HIV infection is a hazardous health threat and its prevalence among pregnant women is a matter of major concern, particularly to prevent vertical HIV transmission to the children. The overall HIV seroprevalence rate was found to be substantial (1.4%) among pregnant women in India who were tested for HIV in antenatal clinics.[5] Regrettably, the HIV status of the studied pregnant woman was not defined. I assume that HIV testing using the diagnostic panel of CD4 lymphocyte count and viral overload estimations was envisaged. If that panel was to disclose HIV seropositivity, the case in question could be obviously regarded a novel case report of HIV-associated PPA in a pregnant woman in the literature.
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Conflicts of interest
There are no conflicts of interest.
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REFERENCES
1. Chinnasamy S, Sundararajan L, Radhakrishnan C, Nambi PS. Pleuropulmonary aspergillosis presenting as hydropneumothorax in second trimester pregnancy. Indian J Respir Care 2019;8:57-9.
2. El Fane M, Ouladlahsen A, Bakhatar A, Sodqi M, El Filali KM, Bahlaoui A, et al. Pulmonary aspergillosis and HIV infection: About two cases. Rev Pneumol Clin 2012;68:36-9.
3. Kaur R, Mehra B, Dhakad MS, Goyal R, Dewan R. Pulmonary aspergillosis as opportunistic mycoses in a cohort of human immunodeficiency virus-infected patients: Report from a tertiary care hospital in North India. Int J Health Sci (Qassim) 2017;11:45-50.
4. Hakkouni AE, Mansouri N. Invasive pulmonary aspergillosis in a patient with human immunodeficiency virus (HIV). Pan Afr Med J 2018;31:40.
5. Shah I, Lala M, Damania K. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008. J Family Med Prim Care 2017;6:240-2.
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