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Subacute invasive pulmonary aspergillosis after chemoradiotherapy for lung cancer

Authors :
Hirofumi Watanabe
Toshihiro Shirai
Mika Saigusa
Kazuhiro Asada
Kazumori Arai
Source :
Respirology Case Reports, Vol 8, Iss 2, Pp n/a-n/a (2020)
Publication Year :
2020
Publisher :
Wiley, 2020.

Abstract

Subacute invasive pulmonary aspergillosis (SIPA), a rapidly progressive fungal infection of less than three months arising from pre‐existing lung lesions, generally afflicts moderately immunocompromised patients. We herein report the case of a 69‐year‐old man who developed SIPA following chemoradiotherapy for lung cancer and treated with antifungal therapy. He presented with fever, and computed tomography revealed a cavity with surrounding consolidation. The cavity itself had been considered as the primary tumour treated by chemoradiotherapy. Bronchoalveolar lavage by bronchoscopy performed at admission identified Aspergillus fumigatus; no other pathogens or malignant cells were observed. Owing to the worsening of symptoms and inflammation despite micafungin administration, the treatment was changed to liposomal amphotericin B with voriconazole, which led to clinical improvement. In addition to cancer recurrence and bacterial infection, fungal infection should also be considered in patients undergoing chemoradiotherapy for lung cancer with deteriorating imaging findings and symptoms. In intractable cases, multiple antifungal drugs are effective.

Details

Language :
English
ISSN :
20513380
Volume :
8
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Respirology Case Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.96aa4ebcb46b4a4bab0c279546f85604
Document Type :
article
Full Text :
https://doi.org/10.1002/rcr2.523