A case of chronic necrotizing pulmonary aspergillosis

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1: Nihon Kokyuki Gakkai Zasshi. 2003 Jul;41(7):469-73. Related

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[A case of chronic necrotizing pulmonary aspergillosis diagnosed

using percutaneous intracavitary endoscopy]

[Article in Japanese]

Niwa T, Nakamura A, Kato T, Kutsuna T, Tonegawa K, Kawai A, Itoh M.

Department of Internal Medicine and Bioregulation, Nagoya City

University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-

cho, Mizuho-ku, Nagoya 467-8602, Japan.

A 65-year-old man with pneumoconiosis visited our hospital for

dyspnea on effort. Chest radiography and computed tomography on

admission showed cavities with an air-fluid level, consolidation in

the right lower lung, and right pleural effusion. The thoracic

cavity and an infected cyst were drained, and antibiotics were

administered. On detection of molds like Aspergillus species and of

aspergillus antigen from the sputum, aspergillosis was suspected and

amphotericin B was administered intravenously. Renal dysfunction

caused by amphotericin B led to its withdrawal. Abnormal shadows in

the chest radiographs and computed tomograms did not improve. To aid

in diagnosis, percutaneous intracavitary endoscopy was performed.

Yellow-white mural nodules resembling cauliflower were found on

endoscopic examination, and a biopsy specimen of the nodules showed

hyphae of Aspergillus. Aspergillus fumigatus was cultured from the

intracavity fluid. Pulmonary aspergillosis was diagnosed and

amphotericin B was administered via the drainage catheter in order

to protect renal function. The abnormal shadows then disappeared and

the subsequent clinical course was good. In this case, percutaneous

intracavitary endoscopy was useful in diagnosing pulmonary

aspergillosis.

Publication Types:

Case Reports

PMID: 12931675 [PubMed - indexed for MEDLINE]