Author:
A Knaz1, A Omrane1, H Chouaieb2, M Chatti2, R Mrassi2, S Ismail2, M Ben Seif2, W Benzarti1, MA Ayed1, A Abdelghani1, A Hayouni1, S Aissa1, I Gargouri1, A Fathallah2*
Author address:
1Department of Pneumology, Farhat Hached University Hospital, Sousse, Tunisia
2Department of Parasitology Mycology, Farhat Hached University Hospital, Sousse, Tunisia
Full conference title:
10th Advances Against Aspergillosis and Mucormycosis
Date: 2 February 2022
Abstract:
Introduction:
Chronic pulmonary aspergillosis is an uncommon and slowly destructive pulmonary disease characterized by progressive cavitations and fibrosis. CPA is seen in immunocompetent or midly immunosuppressed patients with underlying respiratory disorder.
Case report:
We report the case of a 56 -year-old man,caucasian, with GPA having upper respiratory tract involvement and steroid induced diabetes mellitus, in which Aspergillus niger was detected in culture of bronchoalveolar lavage (BAL) after initiating current immunosuppressive therapy and long term corticotherapy for extensive GPA. He was admitted in our pneumology department complaining of clinical signs suggestive of pneumopathy (dyspnea,drycough, low abundance hemoptysis and prolonged fever). Physical examination showed a moderate deterioration general status. Chest CT scan revealed progression in number and size of excavated and unexcavated nodules and architectural distortion with traction bronchiectasis of the left upper lobe.
Ziehl-Neelsen staining for mycobacteria and SARS-Cov-2 PCR were negative. Galactomannan antigen was not detected neither anti-Aspergillus antibody in the patient’s serum. Mycological microscopic examination of BAL sample showed septate hyphae and culture yielded Aspergillus niger.
The diagnosis being difficult, not fulfilling all the criteria for probable chronic pulmonary aspergillosis and sometimes difficult to differentiate from underlying pathology (GPA), the CPA diagnosis was retained above of clinical, radiological and mycological arguments.
The clinical status has been improved under antifungal therapy (voriconazole); the current corticosteroids treatment was also modified being reduced to 15mg of prednisolone daily.
Conclusion:
Pulmonary aspergillosis outcome will be improved with a rapid diagnosis, the administration of antifungal drugs as well as the management of underlying disease. The authors discuss how to manage and treat such aspergillosis risk regarding GPA physiopathology, taking into account the immunosuppressive therapy.
Abstract Number: 20
Conference Year: 2022
Link to conference website: https://aaam2022.org/
URL Conference abstract: