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Pulmonary aspergillosis presenting with recurrent haemoptysis

Blas Y Betancourt1, Adrian C Garofoli1, Jagbir S Sandhu2

  • 1Department of Medicine, Metropolitan Hospital Center, New York and New York Medical College, Valhalla, New York, USA.

BMJ Case Reports
|July 9, 2015
PubMed

Insights

Pulmonary aspergillosis can cause severe bleeding (hemoptysis). This case highlights surgical management of a fungal lung cavity causing persistent hemoptysis, with successful recovery after voriconazole treatment.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Pulmonary aspergillosis encompasses diverse clinical presentations.
  • Hemoptysis is a serious complication, often necessitating surgical intervention.
  • Fungal lung infections can mimic other pathologies, complicating diagnosis.

Observation:

  • A 54-year-old male with prior tuberculosis and diabetes presented with persistent cough and haemoptysis.
  • Chest CT identified a soft tissue mass, and initial conservative treatment failed to resolve recurrent, severe haemoptysis.

Findings:

  • Despite bronchial arterial embolisation, persistent haemoptysis required right upper and middle lobectomy.
  • Histopathology confirmed a fungal cavitary lesion, treated successfully with voriconazole.

Implications:

  • This case underscores the importance of considering fungal infections in patients with risk factors and recurrent haemoptysis.
  • Aggressive management, including surgery and targeted antifungal therapy, can achieve favorable outcomes in complex pulmonary aspergillosis cases.

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