Submitted by: Michael on: 16 April 2013
Case number: 3
A 51 year old ex-smoker with ankylosing spondylitis and some chronic airflow limitation had a previous history of atypical tuberculosis (M. malmoense). The patient developed a large cavity lesion containing an intracavitary fungal ball typical of an aspergilloma. Thoracotomy and resection of the upper lobe was performed. Subsequently, a CT scan demonstrated a left upper zone cavity containing a fluid level with consolidation in the adjacent lung and pleural thickening suspicious radiologically of chronic necrotising pulmonary aspergillosis.At bronchoscopy the bronchial lavage grew A. fumigatus. A course of itraconazole therapy was given for 11 months with improvement in the first 3 months of therapy. In the 24 months since therapy was stopped, no progression of the parenchymal disease was observed.
Species (if applicable): Aspergillus fumigatus