This 73 year old patient with CPA in right upper lobe and COPD who was also a heavy smoker, showed evidence of finger clubbing ( A,B,C). He has been on long term itraconazole, in 1990 he had an oesophagectomy for cancer of the oesophagus. Finger clubbing is an uncommon symptom only seen in advanced or chronic disease. D, chest X ray there are background changes nof COPD with loss of volume in the right hemithorax and a right apical cavititating lesion.
Invasive pulmonary aspergillosis is most commonly seen in immunocompromised patients. Besides, skin lesions may also develop due to invasive aspergillosis in those patients. A 49-year-old male patient was diagnosed with acute myeloid leukemia.
The patient developed bullous and zosteriform lesions on the skin after the 21st day of hospitalization. The skin biopsy showed hyphae. Disseminated skin aspergillosis was diagnosed to the patient.
Voricanazole treatment was initiated. The patient was discharged once the lesions started to disappear.