A Case of Obstructing Bronchial Aspergillosis in a Patient Receiving Cytotoxic Chemotherapy and Inhaled Corticoid Therapy

Abstract

Abstract Background: Among various types of aspergillosis, the clinical feature of patients with obstructive bronchial aspergillosis is still unclear. Originally it was reported it occurs not in severe immunocompromised patients such as acquired immunodeficiency syndrome (AIDS) or post organ transplantation, while recent reports have suggested that this disease could afflict patients seen in daily practice of pulmonary medicine. Case presentation: We describe a case of 76 years old woman with obstructing bronchial aspergillosis. This patient presented to the hospital with a productive coughduring treatment for asthma and advanced lung cancer. Chest CT showed stenosis of the bronchial lumen. Bronchoscopy showed no recurrence of lung cancer, and aspergillus were found in the granulation tissue. Cough improved with debridement of the lesion by bronchoscopy and oral antifungal medication treatment. Conclusion: Our review of previous case reports as well as this case revealed that obstructing bronchial aspergillosis might occur when patients hold several backgrounds inducing immunosuppression such as solid tumors under anticancer treatment, inhaled corticosteroids and aging. As such patients may have risk to progress to invasive aspergillosis, physicians need to keep in mind obstructing bronchial aspergillosis should be properly diagnosed for delivering them appropriate treatment.