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Updated: Jun 23, 2026

Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
09:52

Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis

Published on: March 9, 2018

[A case of pulmonary aspergillosis subacutely forming a cavity during the course of microscopic polyangiitis]

Taisuke Kazuyori1, Arafumi Maeshima, Masako Sakai

  • 1Department of Respiratory Medicine, National Tokyo Medical Center.

Nihon Kokyuki Gakkai Zasshi = the Journal of the Japanese Respiratory Society
|May 22, 2009
PubMed

Insights

A patient with microscopic polyangiitis (MPA) developed pulmonary aspergillosis with a rapidly forming cavity. Antifungal treatment improved the aspergillosis, but the patient later succumbed to a systemic herpesvirus infection.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Rheumatology

Background:

  • Microscopic polyangiitis (MPA) is a rare autoimmune vasculitis that can affect the lungs.
  • Alveolar hemorrhage is a serious complication of MPA, presenting with hemoptysis and diffuse lung infiltrates.
  • Corticosteroid therapy is the mainstay for treating MPA, but long-term use can lead to opportunistic infections.

Observation:

  • A 77-year-old woman with MPA and alveolar hemorrhage presented with hemoptysis.
  • Following initial response to corticosteroids, a nodule with rapid cavity formation developed in the lung.
  • Bronchial washing and biopsy confirmed pulmonary aspergillosis caused by Aspergillus fumigatus.

Findings:

  • The patient's pulmonary aspergillosis cavity responded to micafungin treatment, with decreased serum beta-D-glucan.
  • Despite treatment for fungal infection, the patient ultimately died due to a systemic herpesvirus infection.
  • This case highlights the potential for subacute cavity formation in pulmonary aspergillosis.

Implications:

  • MPA patients on immunosuppression are at risk for opportunistic fungal infections like aspergillosis.
  • Early diagnosis and treatment of pulmonary aspergillosis are crucial in immunocompromised individuals.
  • The case underscores the complex interplay of autoimmune disease, opportunistic infections, and viral reactivation.

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