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Kanai T, Samejima Y, Noda Y, Kim SH, Tamura K, Umakoshi T, Shimizu K, Kashiwa Y, Morishita H, Ueda K, Kawahara K, Yaguchi T, Matsuoka H. Invasive Tracheobronchial Aspergillosis with Bronchial Ulcers Complicated by Nontuberculous Mycobacterial Disease. Intern Med 2020; 59:1189-1194. [PMID: 32009092 PMCID: PMC7270761 DOI: 10.2169/internalmedicine.3827-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Invasive tracheobronchial aspergillosis (ITBA) complicated by nontuberculous mycobacteria (NTM) is rare. An 88-year-old man was admitted for hemoptysis. Bronchoscopy revealed bronchial ulcers, and a tissue biopsy showed Aspergillus fumigatus. He was diagnosed with ITBA, which improved with voriconazole. During treatment, infiltrative shadows appeared in his lungs, and bronchoscopy was performed once again. A non-necrotic epithelioid granuloma and Mycobacterium intracellulare were detected in the biopsy specimen. He was diagnosed with NTM disease. It is important to note that tracheobronchial ulcers may cause hemoptysis and to identify the etiology and treat it appropriately when multiple bacteria are found.
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Affiliation(s)
- Tomohiro Kanai
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Yumiko Samejima
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Yoshimi Noda
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Sung-Ho Kim
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Kanako Tamura
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Taisei Umakoshi
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Kazunori Shimizu
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Yozo Kashiwa
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Hiroshi Morishita
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
| | - Kayo Ueda
- Department of Pathology, Osaka Habikino Medical Center, Japan
| | | | | | - Hiroto Matsuoka
- Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan
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Moribuchi H, Sato R, Matsushima S, Tominaga M, Sasaki J, Nakamura M, Sakazaki Y, Nishiyama M, Hoshino T, Kawayama T. Fulminant Tracheobronchial Aspergillosis in an Apparently Healthy Adult. Intern Med 2020; 59:1295-1298. [PMID: 32418954 PMCID: PMC7303448 DOI: 10.2169/internalmedicine.3857-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 56-year-old healthy man who was a current smoker died from fulminant tracheobronchial aspergillosis despite a month of treatment with a combination of intravenous anti-fungal agents that had been started immediately after the diagnosis. This case report is important for understanding and managing fulminant Aspergillus infections in healthy subjects, although the pathogenesis and underlying pathways are still unknown.
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Affiliation(s)
- Hayato Moribuchi
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Rumi Sato
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
- Respiratory Medicine, Asakura Medical Association Hospital, Japan
| | | | - Masaki Tominaga
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Jun Sasaki
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Masayuki Nakamura
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Yuki Sakazaki
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Mamoru Nishiyama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
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