Multiple pulmonary Aspergillus fumigatus cysts and cavities that disappeared with anti‐fungal agents

Abstract

A 26‐year‐old man with a 10‐year history of asthma was admitted to our hospital with a six‐week history of dry cough and slight fever. We observed the left pneumothorax with multiple cysts and cavities and performed partial cystectomy of the left upper lung. Y‐shaped mycelia were detected in the resected tissue, and Aspergillus fumigatus was cultured. Pulmonary aspergillosis was diagnosed from the histopathological and bacteriological findings, and the patient demonstrated positive immunological reactions to A. fumigatus. After administration of an intravenous antifungal agent for one month and an oral antifungal agent for another three months, all cysts and cavities disappeared. Aspergillus infection usually results from saprophytic growth within pre‐existing cavities. In this case, multiple cysts and cavities may have been caused by Aspergillus, possibly through a check‐valve mechanism.

Disappearance of Pulmonary Cavity caused by Fungal Infection

“…5 Once formed, they often change to linear shadows or remains as cavities, but rarely disappear. 1 Our elderly patient had impaired glucose tolerance. In addition, the patient proved to have left renal cancer one year after this infectious episode.…”

“… 5 Once formed, they often change to linear shadows or remain as cavities but rarely disappear. 1 The current elderly patient had impaired glucose tolerance; in addition, the patient was diagnosed with left renal cancer one year after this infectious episode. It was unclear whether the impaired glucose tolerance and cancer-bearing status in this patient were associated with the fungal infection.…”

“…To the best of the authors’ knowledge, there is one report of a patient with pulmonary fungal infection who followed a similar course until the disappearance of a lung cavity. 1 This was a 26-year-old man with pulmonary aspergillosis, who had bronchial asthma as the underlying disease. 1 Since it was a pulmonary mycosis that developed in a compromised elderly patient, it was speculated that the cavity would remain after treatment.…”

“… 1 This was a 26-year-old man with pulmonary aspergillosis, who had bronchial asthma as the underlying disease. 1 Since it was a pulmonary mycosis that developed in a compromised elderly patient, it was speculated that the cavity would remain after treatment. The patient could be followed-up for a long period of time, even after the inflammatory response had improved and the disappearance of the cavity was unexpectedly confirmed.…”

“…The disappearance of cavities associated with pulmonary fungal infections is rare. 1 A 79-year-old male patient was admitted to a local hospital in Mito-city, Japan, in 2017 complaining of cough and fever for the previous two weeks. The patient had no history of diabetes or tuberculosis.…”