Medicina pulmonar y respiratoria

Rare Presentation of Primary Pulmonary Aspergillosis

Abstract

Sathyasudish N, Vishak KA, Sydney DS, Santosh R, Anand R and Preetam AP

A middle aged female presented with symptoms of chronic cough, breathlessness, fatigue and weight loss of 4 months duration. Chest X-ray (CXR) was suggestive of bilateral upper lobe mass lesion with a differential diagnosis in favour of malignancy. Contrast enhanced computed tomography (CECT) chest showed collapse of right upper lobe and left upper lobe. Bronchoscopy showed thick gelatinous globular plugs occluding both upper lobes and guided biopsy showed granular necrotic debris and dense eosinophilic infiltrates. Her serum immunoglobulin-E (IgE) levels were very high (18,887 IU/ml) and Gomori Methenamine Silver staining was suggestive of Aspergillus sps. She was diagnosed to have Primary pulmonary aspergillosis and treated with itraconazole for 2 months. She responded very well and lung lesions cleared drastically on follow up.