NYMC Faculty Publications

Pulmonary Aspergillosis Presenting With Recurrent Haemoptysis

Author Type(s)

Faculty

DOI

10.1136/bcr-2015-211249.

Journal Title

BMJ Case Reports

Document Type

Article

Publication Date

7-7-2015

Department

Medicine

Second Department

Pathology, Microbiology and Immunology

Keywords

Antifungal Agents, Aspergillus fumigatus, Cough, Hemoptysis, Humans, Male, Middle Aged, Pulmonary Aspergillosis, Recurrence, Treatment Outcome, Tuberculosis, Pulmonary, Voriconazole

Disciplines

Medicine and Health Sciences

Abstract

Pulmonary aspergillosis presents with a variety of clinical forms including invasive pulmonary aspergillosis, chronic necrotising aspergillosis, aspergilloma, chronic cavitary pulmonary aspergillosis and allergic bronchopulmonary aspergillosis. Haemoptysis is a devastating complication of pulmonary aspergillosis and a common indication for surgery. We report a case of a 54-year-old man with a history of pulmonary tuberculosis and diabetes mellitus, who presented with productive cough and haemoptysis for 2 months. Chest CT revealed a 30 mm diameter soft tissue mass in the upper lobe of the right lung. Haemoptysis subsided with conservative measures, but 2 weeks later the patient developed a new episode of persistent haemoptysis, which was only partially controlled with bronchial arterial embolisation. He underwent right upper and middle lobectomy. Histology examination confirmed the presence of a fungal cavitary lesion. The patient was started on voriconazole, and recovered with no recurrence at 18 months follow-up.

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