The history and the clinical and necropsy findings are presented of a patient who died from Aspergillus fumigatus pyaemia occurring as an opportunistic infection complicating a dissecting aortic aneurysm. The diagnosis was made (and treatment instituted) during life: it rested upon repeated isolation of the organism from tracheal aspirations, a positive blood culture and positive serum precipitin reactions to A. fumigatus. Debilitating disease along with large doses of antibiotics and corticosteroids provided the conditions necessary for the normally saphrophytic fungi to become pathogenic. As the therapy for aspergillosis is still ineffective, the danger of prescribing large doses of antibiotics together with corticosteroids is stressed.
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