Original Article
A case report of the invasive tracheobronchial pulmonary Aspergillosis and review of literature
Dong Susu, Pei Wenjun, Wang Tianli, Mei Mu, Tang Zhixin, Zou Yeqiang, Chen Erdong
Published 2019-01-05
Cite as Int J Respir, 2019,39(1): 17-21. DOI: 10.3760/cma.j.issn.1673-436X.2019.01.004
Abstract
ObjectiveTo improve the understanding of clinical characteristics and treatment of invasive tracheobronchial pulmonary Aspergillosis.
MethodsOne case of invasive tracheobronchial pulmonary Aspergillosis without immunedeficiency was reported.Its pathogeny, diagnosis, treatment and prognosis were analyzed, and relevant literatures at home and abroad were reviewed.
ResultsA 50-year-old male patient without immunedeficiency was admitted to the hospital due to cough, expectoration and dyspnea for 5 days.The disease progressed from initial mild lesions to lung parenchymal lesions rapidly.The electronic bronchoscopy showed that the white secretion attached to vocal cord, pseudo-membrane, ulceration and bad death were found in the trachea, and the mucosa on the right upper lobe was uneven.Athological examination showed Aspergillosis and the patient was diagnosed with invasive tracheobronchial pulmonary Aspergillosis.After 3 months of treatment by voriconazole, the symptoms of patient disappeared and the lung lesions were basically absorbed.
ConclusionsInvasive tracheobronchial pulmonary Aspergillosis occurs mainly in patients with severe immunodeficiency, but it may also occur in patients with normal immune function, which may be associated with influenza infection.Its clinical manifestations are atypical, so it is easily misdiagnosed.Timely bronchoscopy is helpful for early diagnosis and treatment.Invasive tracheobronchial Aspergillosis may be an early stage of invasive pulmonary Aspergillosis.According to the host immune status and the degree of Aspergillus invading the bronchus, the treatment of invasive tracheobronchial Aspergillosis needs to be individualized.
Key words:
Aspergillosis; Glottis; Trachea; Bronchus; Lung
Contributor Information
Dong Susu
Department of Respiratory Medicine, the First People′s Hospital of Changde, Changde 415000, China
Pei Wenjun
Wang Tianli
Mei Mu
Tang Zhixin
Zou Yeqiang
Chen Erdong