Invasive pulmonary aspergillosis: radiologic evidence of tracheal involvement.

Chest radiographs of invasive pulmonary aspergillosis in immunocompromised patients typically show ill-defined pulmonary nodules. Direct tracheal involvement has not been previously documented radiologically. Radiographs and CT scans of a 16-year-old boy with aplastic anemia and invasive pulmonary aspergillosis showed increased paratracheal opacity, tracheal narrowing, and pneumomediastinum in combination with pulmonary disease. Bronchial lavage cultures grew Aspergillus fumigatus, and the boy died 24 days later.