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Lee, Jun, Song, Shin, Kim, Park, Choi, Choi, and Kim: A Case of Pseudomembranous Necrotizing Bronchial Aspergillosis in An Old Age Host
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(3): 278-282.

Published online: 30 September 2007

DOI: https://doi.org/10.4046/trd.2007.63.3.278

A Case of Pseudomembranous Necrotizing Bronchial Aspergillosis in An Old Age Host

Seung Eun Lee, M.D.1, Eun Ju Jun, M.D.1, Ju Han Song, M.D.1, Jong Wook Shin, M.D.1, Jae Yeol Kim, M.D.1, In Whon Park, M.D.1, Byoung Whui Choi, M.D.1, Jae Chol Choi, M.D.1, Mee Kyoung Kim, M.D.2

1Division of Pulmonary and Critical Care Medicine, Chung-Ang University, Seoul, Korea.

2Division of Pathology, Chung-Ang University, Seoul, Korea.

Address for correspondence: Jae Chol Choi, M.D. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Young San Hospital, Han Gang Ro 3 GA, Young San Gu, Seoul 140-757, Korea. Tel: 82-22-748-9804, Fax: 82-2-748-9529, medics27@cau.ac.kr

Received 9 July 2007       Accepted 20 August 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Invasive aspergillus tracheobronchitis is uncommon manifestation of infection due to Aspergillus species, occurring in severely immunocompromised patients who are generally neutropenic with haematological diseases, AIDS, or after heart and lung transplantation. The pseudomembranous form is the most severe condition and is usually fatal despite treatment with antifungal agents. However, there are a few cases reported with no apparent severe compromise in the host defences. We encountered a pseudomembranous necrotizing bronchial aspergillosis in a 73-year old male patient, who was treated successfully with antifungal agents.

Keywords: Aspergillosis, Pseudomembranous, Tracheobronchitis

Figures and Tables

Figure 1
A chest radiograph on admission demonstrates pneumonic infiltration in left upper lung field and right lower lung field.
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Figure 2
Chest CT scan demonstrates peribronchial necrotizing consolidations with centrilobular nodules (A), and diffuse bronchial wall thickening (B).
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Figure 3
Brochoscopic picture demonstrates extensive whitish exudative membranes covering the left upper lobe bronchus(A) and upper division (B).
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Figure 4
The bronchoscopic biopsy shows numerous branching hyphae with septation.(H&E, ×400)
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Figure 5
Follow up brochoscopic view of left upper lobe bronchus showing improved Inflammation with minimal whitish exudative membranes: (A) left main bronchus; (B) left upper lobe bronchus.
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References

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