TY - JOUR
T1 - Systemic dissemination of chronic necrotizing pulmonary aspergillosis in an elderly woman without comorbidity
T2 - A case report
AU - Tokui, Kotaro
AU - Kawagishi, Yukio
AU - Inomata, Minehiko
AU - Taka, Chihiro
AU - Okazawa, Seisuke
AU - Yamada, Toru
AU - Miwa, Toshiro
AU - Hayashi, Ryuji
AU - Matsui, Shoko
AU - Takano, Yasuo
AU - Tobe, Kazuyuki
PY - 2012
Y1 - 2012
N2 - Introduction. Chronic necrotizing pulmonary aspergillosis usually occurs in mildly immune-compromised hosts or those with underlying pulmonary disease. The radiographic pattern of chronic necrotizing pulmonary aspergillosis is typically a progressive upper lobe cavitary infiltrate with pleural thickening. We report here an atypical case of chronic necrotizing pulmonary aspergillosis mimicking lung cancer, which developed into a disseminated fatal disease in an older woman with no comorbidity. Case presentation. An 80-year-old Japanese woman was referred to our hospital for a chest roentgenogram abnormality. Repeated fiber-optic bronchoscopy could not confirm any definite diagnosis, and she refused further examinations. Considering the roentgenogram findings and her age, she was followed-up as a suspected case of lung cancer without any treatment. Then, 10 months later, she complained of visual disturbance and was admitted to our department of ophthalmology. She was diagnosed as having endophthalmitis. After treatment with corticosteroids for 20 days, she developed acute encephalitis and died four weeks later. Autopsy revealed dissemination of Aspergillus hyphae throughout her body, including her brain. Conclusions: In older patients, even if they do not have any comorbidity, chronic necrotizing pulmonary aspergillosis should be added to the differential diagnosis of solitary pulmonary lesions in a chest roentgenogram.
AB - Introduction. Chronic necrotizing pulmonary aspergillosis usually occurs in mildly immune-compromised hosts or those with underlying pulmonary disease. The radiographic pattern of chronic necrotizing pulmonary aspergillosis is typically a progressive upper lobe cavitary infiltrate with pleural thickening. We report here an atypical case of chronic necrotizing pulmonary aspergillosis mimicking lung cancer, which developed into a disseminated fatal disease in an older woman with no comorbidity. Case presentation. An 80-year-old Japanese woman was referred to our hospital for a chest roentgenogram abnormality. Repeated fiber-optic bronchoscopy could not confirm any definite diagnosis, and she refused further examinations. Considering the roentgenogram findings and her age, she was followed-up as a suspected case of lung cancer without any treatment. Then, 10 months later, she complained of visual disturbance and was admitted to our department of ophthalmology. She was diagnosed as having endophthalmitis. After treatment with corticosteroids for 20 days, she developed acute encephalitis and died four weeks later. Autopsy revealed dissemination of Aspergillus hyphae throughout her body, including her brain. Conclusions: In older patients, even if they do not have any comorbidity, chronic necrotizing pulmonary aspergillosis should be added to the differential diagnosis of solitary pulmonary lesions in a chest roentgenogram.
UR - http://www.scopus.com/inward/record.url?scp=84865542457&partnerID=8YFLogxK
U2 - 10.1186/1752-1947-6-270
DO - 10.1186/1752-1947-6-270
M3 - 学術論文
C2 - 22938191
AN - SCOPUS:84865542457
SN - 1752-1947
VL - 6
JO - Journal of Medical Case Reports
JF - Journal of Medical Case Reports
M1 - 270
ER -