Chronic necrotizing pulmonary aspergillosis
Author:
Parra I, Remacha A, Rezusta A, Suarez D, Suarez J, Herreras JA, Gonzalez JR.
Date: 19 October 2004
Abstract:
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.
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