title: [A case of pulmonary aspergillosis subacutely forming a cavity during the course of microscopic polyangiitis].
abstract: A 77-year-old woman was referred to our department with hemoptysis. Microscopic polyangiitis (MPA) with resultant alveolar hemorrhage was diagnosed because of diffuse infiltrate of the right lung, proteinurea, renal dysfunction and the presence of MPO-ANCA. The disease responded well to corticosteroid therapy. She was discharged, but as corticosteroid was gradually tapered, an irregularly-shaped nodule appeared in the right upper lung field within 2 weeks. She was re-admitted because the nodule increased in size with cavity formation in spite of the administration of antibacterial agent. Pulmonary aspergillosis was diagnosed, since bronchial washing and transbronchial lung biopsy revealed the presence of Aspergillus fumigatus. Serum beta-D-glucan was decreased and the cavity was reduced in size, responding to the treatment with micafungin. However, she died later of systemic infection by a herpesvirus. We report this case because of the interesting course of pulmonary aspergillosis that subacutely formed a cavity.
authors.affiliation: Department of Respiratory Medicine, National Tokyo Medical Center.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Kazuyori
authors.forename: Arafumi
authors.initials: A
authors.lastname: Maeshima
authors.forename: Masako
authors.initials: M
authors.lastname: Sakai
authors.forename: Kumi
authors.initials: K
authors.lastname: Shimizu
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kurata
authors.forename: Hiromi
authors.initials: H
authors.lastname: Seki
authors.forename: Misa
authors.initials: M
authors.lastname: Wakaki
authors.forename: Taichiro
authors.initials: T
authors.lastname: Goto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Saitou
authors.forename: Akio
authors.initials: A
authors.lastname: Onaka
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Kato
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Oyamada
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D055732:Pulmonary Aspergillosis / Q000150:complications* / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy