Mediastinal aspergillosis of an immunocompetent host

Aspergillus species are well-known opportunistic pathogens that can cause different infections, and are commonly seen in immunocompromised hosts. Invasive aspergillosis in an immunocompetent patient with extension to the mediastinum has been reported rarely. We report a case of a young male patient who had a huge mass lesion that is seen at the right side of mediastinum at lower paratracheal region, extending up to the hilum and pretracheal location. It was primarily diagnosed as pericardial cyst/right ventricular thrombus. The patient was diagnosed with aspergillosis caused by Aspergillus flavus by histopathology, staining, and fungal culture. The patient was treated with voriconazole and he was discharged after clearly advising the need for therapy. The patient did not come for the follow-up checkup and later when communicated, we came to knew that the patient had expired due to breathlessness.