title: Chronic necrotizing pulmonary aspergillosis following cryptococcal infection of the lung.
abstract: A 64-y-old male with steroid-induced diabetes mellitus was admitted to our hospital because of a nodular shadow found by chest radiography. Pathological examination revealed pulmonary cryptococcosis, and he was positive for serum Cryptococcus antigen. After oral treatment with fluconazole, he experienced clinical and radiographic improvement, but during ensuing observation without antifungal treatment his respiratory symptoms gradually worsened. Chest radiography showed progressive infiltration around the cavity, and Aspergillus mold was isolated by transbronchial lung biopsy from the lesion where previous cryptococcal infection was present. In addition, serum antibodies to Aspergillus antigens were demonstrated by immunodiffusion. Thus, pulmonary aspergillosis was found to complicate a case of pulmonary cryptococcal infection.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kitazaki
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Osumi
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kihara
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kinoshita
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Tsuji
authors.forename: Masahiro
authors.initials: M
authors.lastname: Itoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Soda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D001228:Aspergillosis / Q000150:complications* / Q000382:microbiology; D001230:Aspergillus / Q000302:isolation & purification; D002908:Chronic Disease; D003453:Cryptococcosis / Q000150:complications* / Q000382:microbiology; D003454:Cryptococcus / Q000302:isolation & purification; D006801:Humans; D008168:Lung / Q000382:microbiology; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009336:Necrosis