Yuan Ming-Li, Yang Gang, Hu Hong-Ling, Yin Wen, Tan Wei-Jun, Zhao Su
Department of Respiratory Medicine, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Jiang'an, Wuhan, China.
Indian J Pathol Microbiol. 2017 Apr-Jun;60(2):285-287. doi: 10.4103/IJPM.IJPM_248_16.
Aspergillus tracheobronchitis (AT) is a unique form of invasive pulmonary aspergillosis, which is commonly found in patients with impaired immunity. Early-stage AT presents in a nonspecific way, both clinically and radiographically, thereby delaying diagnosis and resulting in a high mortality. Owing to impaired mucociliary clearance, previous nonfungal infections, and administration of corticosteroids, among other aspects, patients with chronic obstructive pulmonary disease (COPD) are predisposed to AT, although they are mostly immunocompetent. AT in COPD patients has not been well recognized and the condition is often misdiagnosed or missed. We herein report a case of AT diagnosed in a male with past COPD, with the features of pseudomembranous AT upon bronchoscopy. This contradicts the opinion that pseudomembranous AT is found in severely immunocompromised hosts with hematologic malignancies.
曲霉性气管支气管炎（AT）是侵袭性肺曲霉病的一种独特形式，常见于免疫功能受损的患者。早期AT在临床和影像学上均以非特异性方式表现，从而延迟诊断并导致高死亡率。由于黏液纤毛清除功能受损、既往非真菌性感染以及使用皮质类固醇等因素，慢性阻塞性肺疾病（COPD）患者尽管大多免疫功能正常，但仍易患AT。COPD患者中的AT尚未得到充分认识，病情常被误诊或漏诊。我们在此报告一例既往有COPD的男性患者被诊断为AT的病例，该患者支气管镜检查显示为假膜性AT。这与假膜性AT见于患有血液系统恶性肿瘤的严重免疫功能低下宿主的观点相矛盾。
