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Abstract

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Article in Japanese

Case Report

Autopsy case of airway invasive pulmonary aspergillosis in a patient with asthma-chronic obstructive pulmonary disease overlap

Yoshitomo Kushima  Yasuo Shimizu  Yuka Amagai  Nobuhiko Uchida  Tatsuya Yokoyama  Yoshiki Ishii 

Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University

ABSTRACT

A 73-year-old man with asthma showed a deterioration in respiratory symptoms due to bronchopneumonia and received systemic corticosteroids and antibiotics. However, his respiratory symptoms progressed rapidly, and he was transferred to our hospital. Chest computed tomography did not reveal any obvious cavitation or prominent infiltration. Airway invasive pulmonary aspergillosis (IPA) was diagnosed because of a positive sputum culture for aspergillus, a positive blood titer for aspergillus antigen, and detection of pseudomembrane formation in the bronchi by bronchoscopic examination. Despite initiation of anti-fungal therapy and mechanical ventilation, the patient died 12 days after admission to our hospital. Autopsy revealed IPA associated with asthma-chronic obstructive pulmonary disease (COPD) overlap. In COPD patients, the mortality rate of IPA is high because of difficulty in making a diagnosis and delayed initiation of therapy. Physicians should pay attention to the possibility of IPA in patients with asthma and/or COPD receiving corticosteroid therapy.

KEYWORDS

Invasive pulmonary aspergillosis (IPA)  Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO)  Steroid  Airway 

Received 4 Sep 2018 / Accepted 26 Nov 2018

AJRS, 8(2): 102-107, 2019

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