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Published on: March 9, 2018

[A case of pulmonary infection induced by both Aspergillus sp. and Mycobacterium tuberculosis during corticosteroid

Yoshihiro Kobashi1, Niro Okimoto, Toshiharu Matsushima

  • 1Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Kawasaki Hospital, Nakasange 2-1-80, Okayama 700-8505, Japan.

Nihon Kokyuki Gakkai Zasshi = the Journal of the Japanese Respiratory Society
|April 27, 2002
PubMed

Insights

This case study highlights a rare mixed pulmonary infection of tuberculosis and aspergillosis in an elderly woman with idiopathic thrombocytopenic purpura. Prolonged corticosteroid use increased susceptibility to these opportunistic infections.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Immunology

Background:

  • An 83-year-old woman with idiopathic thrombocytopenic purpura (ITP) was on long-term corticosteroid therapy.
  • Initial diagnosis of pulmonary aspergillosis was treated successfully with itraconazole.

Observation:

  • Corticosteroid dose escalation due to ITP exacerbation led to a new pulmonary infiltrate.
  • Diagnostic workup revealed co-infection with Mycobacterium tuberculosis and Aspergillus species.

Findings:

  • Mycobacterium tuberculosis was identified using the DDH method.
  • Aspergillus species were isolated from sputum, and serological tests for aspergillus antigen were positive.
  • The patient presented with a mixed pulmonary infection, indicating opportunistic pathogen susceptibility due to immunosuppression.

Implications:

  • Prolonged corticosteroid use significantly increases the risk of opportunistic infections like tuberculosis and aspergillosis.
  • This case underscores the importance of vigilant monitoring for secondary infections in immunocompromised patients.
  • Diagnosis and management of co-infections require a comprehensive approach, considering both bacterial and fungal pathogens.

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