Invasive aspergillosis: a life-threatening complication of short-term steroid treatment.
OBJECTIVE
To describe a patient with invasive pulmonary aspergillosis related to short-term steroid treatment.


METHODS
A 78-year-old man with chronic obstructive pulmonary disease (COPD) developed an invasive pulmonary aspergillosis after short-term (less than 1 week) intravenous steroid therapy. The diagnosis was established by recovering Aspergillus fumigatus from a bronchoalveolar lavage and was confirmed by autopsy, with the additional finding of an aspergilloma.


CONCLUSIONS
This case is of interest for 3 reasons: (1) it illustrates that invasive aspergillosis may be followed by a rapidly progressive respiratory failure, even in the absence of a fever; (2) this patient had simultaneously an aspergilloma and an invasive aspergillosis; and (3) it confirms reports indicating that short-term steroid therapy for COPD represents a significant risk factor for opportunistic lung infections.


CONCLUSIONS
In patients with COPD who receive even short-term steroid therapy and who have progressive respiratory failure caused by pneumonia, invasive aspergillosis should be suspected early and acted upon accordingly.
Conesa
D
D
Internal Medicine Department, Hospital de Sabadell, Barcelona, Spain.
Rello
J
J
Vallés
J
J
Mariscal
D
D
Ferreres
J C
JC
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001228:Aspergillosis / Q000139:chemically induced*; D017809:Fatal Outcome; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects*; D008172:Lung Diseases, Fungal / Q000188:drug therapy*; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects*
D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone; D008775:Methylprednisolone