Chronic Cavitary Pulmonary Aspergillosis and Aspergilloma with Atypical Tuberculosis and Emphysema

Case number: 

4

Summary: 

A 73 year old lady with smoking-related emphysema was admitted to hospital in September 1997 with a one-week history of haemoptysis. She had previously been in good health up until February 1995 when she contracted pulmonary tuberculosis infection due to M. malmoense. She received anti-tuberculosis therapy for one year and was left with a substantial cavity in the left upper lobe (7cm2). At that time her Afpptns were negative and IgE was 16iu/ml. Subsequently all investigations for mycobacteria were negative. She improved and then deteriorated again with a cough, mild shortness of breath and 6kg weight loss. On admission a chest radiograph and CT scan revealed the presence of an aspergilloma in the left upper lobe cavity, sputum cultures grew A. fumigatus.

Species: 

  • Aspergillus fumigatus