Chronic necrotizing pulmonary aspergillosis.
Chronic necrotizing pulmonary aspergillosis is not common and usually involves mildly immunosuppressed patients. We present a case of a 58-year-old man with a history of mining-related pneumoconiosis and corticosteroid therapy who developed bilateral pulmonary infiltrates and subsequent cavitation. The patient was treated at first as having community-acquired pneumonia and was only belatedly diagnosed as suffering from aspergillosis after Aspergillus fumigatus precipitins appeared in blood and the same fungus grew from bronchoalveolar lavage fluid. A transthoracic needle biopsy revealed fungal filaments present in material extracted from a pulmonary lesion that was visible on scans. Treatment with amphotericin B, begun at the time that aspergillosis was diagnosed, proved to be ineffective, as was a later change to amphotericin B lipid complex. The diagnosis was confirmed at necropsy.
Parra
Isabel
I
Department of Respiratory Medicine, Hospital Monte San Isidro, León, Spain. isabelparra@hotmail.com
Remacha
Antonia
A
Rezusta
Antonio
A
Suarez
Dimas
D
Suarez
José
J
Herreras
José Antonio
JA
González
José Ramón
JR
D001228:Aspergillosis / Q000000981:diagnostic imaging / Q000382:microbiology*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D002908:Chronic Disease; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D014057:Tomography, X-Ray Computed