Autopsy Case of Pulmonary Aspergillosis Soon after Convalescence from Pulmonary Tuberculosis

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  • 肺結核治癒後早期に発症した肺アスペルギルス症の1剖検例
  • ハイケッカク チユ ゴ ソウキ ニ ハッショウ シタ ハイ アスペルギルスショウ ノ 1 ボウケンレイ

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Abstract

A 70-year-old man with liver cirrhosis and previous gastrectomy admitted for fever, coughing, and bloody sputum soon after convalescing from pulmonary tuberculosis had a peripheral white blOod celi count of 9, 900;/μL, C-reactive protein of 14.1mg/dL, serum albumin of 2.0g/dL, and serum positive for antiaspergillus and β-D-glucan antibodies. Chest radiography showed thickening of the walls of the large residual cavities with previous tuberculosis lesions and infiltrates around them. On day 2 of hospitalization, Aspergillus fumigatuswithout other bacillus was detected in sputum culture taken on admission. Despite immediate treatment with intravenous micafungin and oral itraconazole and improved brief initial improvement, his general condition abruptly deteriorated into frequent massive hemoptysis and he developedt of shock, respiratory failure, and severe malnutrition, dying 30 days later. Autopsy findings showed pulmonary aspergillosis in and around the large cavities and on the other side of the lungs. Pulmonary aspergillosis without hematological malignanciy and immunosuppression can thus be abruptly severe and fatal due to malnourishment stemming from preexisting conditions such as chronic hepatitis despite prompt, ordinarily adequate medical treatmen.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 79 (12), 957-963, 2005

    The Japanese Association for Infectious Diseases

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