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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of chronic progressive pulmonary aspergillosis due to Aspergillus tubingensis treated with combination antifungal drug therapy

Hisashi Hashimotoa  Harumi Koizumib  Ayami Kanekoc  Hiroaki Fujiib  Katsuhiko Kameid  Takeshi Kanekoa 

aDepartment of Pulmonology, Yokohama City University Graduate School of Medicine
bDepartment of Pulmonology, Yokohama Minami Kyousai Hospital
cDepartment of Pulmonology, Yokohama City University Medical Center
dMedical Mycology Research Center, Chiba University

ABSTRACT

A 67-year-old man presented to our hospital with fever of 3 weeks’ duration. Chest computed tomography (CT) showed marked infiltrates in the right upper lobe and mild emphysema. Since he did not respond to antibiotic therapy, we performed a bronchoscopy. Aspergillus niger was detected in bronchial lavage fluid culture obtained from the right upper lobe. He was diagnosed with chronic progressive pulmonary aspergillosis due to Aspergillus niger. Voriconazole, liposomal amphotericin B (L-AMB), and their combination with caspofungin (CPFG) had no effect. Identification of bacterial species and a drug susceptibility test were reperformed, which identified Aspergillus tubingensis. Based on the results of the drug susceptibility test, L-AMB, CPFG, and flucytosine (5-FC) combination therapy was started. Three months later, his symptoms had improved, and a small improvement was observed on CT when compared to the findings on admission. Drug susceptibility tests are a useful tool in the treatment of pulmonary aspergillosis, which is difficult to treat.

KEYWORDS

Chronic progressive pulmonary aspergillosis (CPPA)  Combination therapy  Aspergillus tubingensis  Aspergillus niger 

Received 17 Jul 2020 / Accepted 30 Nov 2020

AJRS, 10(2): 158-162, 2021

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