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Article in Japanese
Abstract
Case Report
A case of chronic pulmonary aspergillosis that developed into the allergic type, and moreover to the invasive type following steroid treatment
Haruka Takahashi Tatsuru Ishikawa Midori Hashimoto Kaoru Nishiyama
Department of Respiratory Medicine, NTT-East Sapporo Hospital
ABSTRACT
A 73-year-old male with a residual cavity developed eosinophilia during treatment of pulmonary actinomycosis. After 8 months of antibiotic administration, he suffered from wheezing and dyspnea. Chest computed tomography showed thickening of the cavity wall and intrabronchial mucoid impaction, and sputum was positive for Aspergillus fumigatus. He was diagnosed with allergic bronchopulmonary aspergillosis (ABPA) and was treated with methylprednisolone. However, the pulmonary lesions deteriorated and were accompanied by fever, which was thought to develop into invasive pulmonary aspergillosis (IPA) after steroid treatment for 7 days. He was treated with combination antifungal therapy. We considered that this case underwent development from chronic Aspergillus infection in the residual cavity to ABPA and moreover progressed to IPA triggered by steroid treatment.
KEYWORDS
Allergic bronchopulmonary aspergillosis (ABPA) Invasive pulmonary aspergillosis (IPA) Steroid Antifungal therapy Mepolizumab
Received 25 Feb 2019 ／ Accepted 12 Sep 2019
AJRS, 9(1): 13-17, 2020
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