title: Pulmonary aspergillosis presenting with recurrent haemoptysis.
abstract: Pulmonary aspergillosis presents with a variety of clinical forms including invasive pulmonary aspergillosis, chronic necrotising aspergillosis, aspergilloma, chronic cavitary pulmonary aspergillosis and allergic bronchopulmonary aspergillosis. Haemoptysis is a devastating complication of pulmonary aspergillosis and a common indication for surgery. We report a case of a 54-year-old man with a history of pulmonary tuberculosis and diabetes mellitus, who presented with productive cough and haemoptysis for 2 months. Chest CT revealed a 30 mm diameter soft tissue mass in the upper lobe of the right lung. Haemoptysis subsided with conservative measures, but 2 weeks later the patient developed a new episode of persistent haemoptysis, which was only partially controlled with bronchial arterial embolisation. He underwent right upper and middle lobectomy. Histology examination confirmed the presence of a fungal cavitary lesion. The patient was started on voriconazole, and recovered with no recurrence at 18 months follow-up.
authors.affiliation: Department of Medicine, Metropolitan Hospital Center, New York and New York Medical College, Valhalla, New York, USA.
authors.forename: Blas Y
authors.initials: BY
authors.lastname: Betancourt
authors.affiliation: Department of Medicine, Metropolitan Hospital Center, New York and New York Medical College, Valhalla, New York, USA.
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Garofoli
authors.affiliation: Department of Pathology, Metropolitan Hospital Center, New York and New York Medical College, Valhalla, New York, USA.
authors.forename: Jagbir S
authors.initials: JS
authors.lastname: Sandhu
authors.affiliation: Department of Medicine, Metropolitan Hospital Center, New York and New York Medical College, Valhalla, New York, USA.
authors.forename: Noella
authors.initials: N
authors.lastname: Boma
authors.affiliation: Department of Medicine, Metropolitan Hospital Center, New York and New York Medical College, Valhalla, New York, USA.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Sy
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D003371:Cough / Q000209:etiology*; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000150:complications* / Q000188:drug therapy; D012008:Recurrence; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D065819:Voriconazole / Q000008:administration & dosage*
chemical_list: D000935:Antifungal Agents; D065819:Voriconazole