Burhan Sami KALIN, Seher YANATMA, Ahmet DÜZGÜN, Ali İhsan SERT
Türk Yoğun Bakım Dergisi - 2026;24(2):147-151
Objective: Invasive pulmonary aspergillosis (IPA) is a life-threatening fungal infection that predominantly affects immunocompromised individuals. Environmental exposure to large amounts of construction dust following natural disasters may also increase the risk of invasive fungal infections. We aimed to present a fatal case of IPA that developed in an earthquake survivor rescued from prolonged entrapment under collapsed buildings. Methods: A female earthquake victim with no known chronic disease or history of immunosuppressive therapy was admitted to the intensive care unit (ICU) after prolonged entrapment under rubble, cardiac arrest, and severe crush-related complications. Clinical findings, microbiological results, imaging studies, treatment course, and outcome were retrospectively reviewed. Results: The patient developed septic shock, acute kidney injury requiring renal replacement therapy, and persistent respiratory failure. Despite broad-spectrum antimicrobial therapy, fever and hypoxemia persisted. Thoracic computed tomography revealed multiple pulmonary nodular lesions and consolidations suggestive of invasive fungal infection. Aspergillus fumigatus was isolated from endotracheal aspirate cultures on the 17th day of ICU admission. Voriconazole therapy was initiated; however, the patient died on the 35th day of ICU hospitalization. Conclusion: IPA should be considered in critically ill survivors of natural disasters, even in the absence of classical host-related risk factors. Early recognition of invasive fungal infections in patients exposed to substantial environmental dust and debris may facilitate timely antifungal treatment and potentially improve outcomes.
