Pleural Aspergillosis

Submitted by: Michael on: 16 April 2013

Case number: 20

Summary:

A 28 year old Caucasian man suffered a long, complicated course of definite pulmonary aspergillosis (aspergillus empyema). A chest CT showed multiple interconnected localized cavities in R lung with significant amount of fluid in the thorax, and a suspect focus in central R lung, the patient was taken to theatre where a right pleuro-pneumonectomy was performed. Persistent infection, despite treatrment, necessitated a “Claggit-cave” surgical procedure to mechanically clean for Aspergillus in R hemithorax. His disease was refractory to Amphotericin B and itraconazole initially and then to Abelcet (failure to improve for Amphotericin B and Abelcet, progression of disease for itraconazole). He was treated with caspofungin thereafter for 114 days with notable clinical improvement.

Species (if applicable): Aspergillus fumigatus

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Choose aspergillosis groupingAcute invasive pulmonary aspergillosisAllergic aspergillosisAspergillomaChronic cavitary pulmonary aspergillosisOther invasive diseaseOther types of aspergillosisPaediatric AspergillosisPrimary pulmonary aspergillosisSevere Asthma with Fungal SensitisationSinus aspergillosis in non-immunocompromisedSubacute invasive (chronic necrotizing) pulmonary aspergillosis