Large mediastinal mass in a 15-year-old boy

BMJ Case Rep. 2018 Nov 8:2018:bcr2018226074. doi: 10.1136/bcr-2018-226074.


Hyperimmunoglobulin E syndrome is a rare multisystem inherited disorder characterised by high serum IgE levels, skin disorder causing eczema, dermatitis, recurrent staphylococcal infections and pulmonary infections and various skeletal and connective tissue abnormalities. Common presentation is with recurrent skin and sinopulmonary infections. Several features unrelated to immune system such as characteristic facial features, hyperextensibility of joints, multiple bone fractures and craniosynostosis have been described in the literature. We describe a rare presentation of this disease with invasive aspergillosis presenting as mediastinal mass with extension to mediastinal structures and pulmonary vasculature.

Keywords: dermatology; immunology; pneumonia (infectious disease).

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use
  • Biopsy
  • Bronchoscopy
  • Diagnosis, Differential
  • Humans
  • Job Syndrome / complications*
  • Job Syndrome / diagnosis*
  • Job Syndrome / surgery
  • Male
  • Mediastinum / diagnostic imaging*
  • Mediastinum / surgery
  • Pulmonary Aspergillosis / complications*
  • Pulmonary Aspergillosis / diagnosis*
  • Pulmonary Aspergillosis / drug therapy
  • Radiography, Interventional
  • Tomography, X-Ray Computed
  • Voriconazole / therapeutic use


  • Antifungal Agents
  • Voriconazole