title: An overwhelming pulmonary fungus ball in a systemic lupus erythematosus patient.
abstract: Impaired host immunity has been regarded as a predisposing factor in post-primary tuberculosis in adults. Patients with systemic lupus erythematosus (SLE) are usually exposed to high doses of corticosteroids and eventually develop defective cellular immunity that increases the risk for active tuberculosis. SLE-associated pulmonary tuberculosis tends to have a higher incidence of miliary, far-advanced pulmonary disease and therefore establishing the diagnosis can easily be delayed due to generalized, non-specific clinical symptoms such as fever, malaise and weight loss which are also commonly observed in lupus patients. However, cavitary tuberculosis is very rare in patients with SLE. To the best of our knowledge, fungus ball formation in the tuberculosis cavity in a patient with SLE, has not been previously reported. Thus, we present a case of SLE who was found to have a fungus ball within a preexisting tuberculosis cavity. The diagnosis was resolved by computerized tomography of the chest and was confirmed with histopathological examination.
authors.affiliation: Department of Radiology, Firat University, Faculty of Medicine, 23119 Elazig, Turkey. ekocakoc@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Kocakoc
authors.forename: S
authors.initials: S
authors.lastname: Ozgocmen
authors.forename: A
authors.initials: A
authors.lastname: Kiris
authors.forename: L
authors.initials: L
authors.lastname: Ozcakar
authors.forename: Y
authors.initials: Y
authors.lastname: Boztosun
authors.forename: N
authors.initials: N
authors.lastname: Yildirim
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D001228:Aspergillosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D009894:Opportunistic Infections / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011013:Pneumonectomy; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone