Chronic fibrosing pulmonary aspergillosis with TB and smoke inhalation

Case History Name: 

Case number: 

40

Summary: 

This woman developed tuberculosis and later suffered severe smoke inhalation. A few years after this, the first signs of chronic cavitary pulmonary aspergillosis developed. She resisted resection surgery, but remained unwell. Gradually, without antifungal treatment her left hemithorax developed larger and larger cavities, with aspergillomas visible. Eventually the whole hemithorax became opacified, and a biopsy showed chronic inflammation and fibrosis. Her symptoms of weight loss and fatigue, with haemoptysis, were improve dslightly with IV amphotericin, but improved markedly with a combination of itraconazole and gamma interferon. She was then maintained on oral itraconazole for several years with reasonable disease control, but no improvement of fibrosis or pulmonary function.

Species: 

  • Aspergillus fumigatus