Invasive Aspergillus Tracheobronchitis Presenting as Subglottic Stenosis: A Case Report

Invasive Aspergillus tracheobronchitis (IATB) is a rare but potentially fatal manifestation of invasive aspergillosis. Because of its high mortality, prompt recognition and initiation of antifungal therapy are crucial. We report the case of a 71-year-old woman with a history of diffuse large B-cell lymphoma (DLBCL) who presented with progressive dyspnea. Computed tomography revealed subglottic airway stenosis, necessitating an emergency tracheostomy to secure the airway. Histopathological and microbiological examination of bronchoscopic biopsy specimens demonstrated infiltration of Aspergillus fumigatus, establishing the diagnosis of IATB. Antifungal therapy with voriconazole was promptly initiated, resulting in gradual clinical and endoscopic improvement. The tracheostomy tube was successfully removed, and the airway lesion showed complete resolution. This case underscores the importance of early diagnosis and timely antifungal therapy to achieve a favourable outcome. When severe airway obstruction is present, airway interventions such as tracheostomy may be lifesaving.