Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
BMJ Case Rep. 2021 Aug 2;14(8):e241655. doi: 10.1136/bcr-2021-241655.
Chronic cavitary pulmonary aspergillosis (CCPA) is a slow destructive type of chronic pulmonary aspergillosis, characterised by multiple pulmonary cavities that develop and expand over several months or years. Pleural involvement in the form of pneumothorax has been rarely reported in CCPA. We report such an unusual case of an immunocompromised male, with a history of chronic cough and fever, presenting with acute onset of shortness of breath. Chest imaging showed bilateral multiple cavitating nodules, ground glass opacities and dense right middle lobe consolidations and right-sided pneumothorax. Bronchoalveolar lavage (BAL) showed septate hyaline hyphae on KOH (potassium hydroxide) staining and fungal culture grew BAL and serum galactomanan were positive and serum IgG for was 58 MgA/L (0-40MgA/L) confirming the cause of spontaneous secondary pneumothorax in our patient as CCPA.
慢性空洞性肺曲霉病（CCPA）是一种缓慢破坏性的慢性肺曲霉病，其特征是多个肺空洞在数月或数年内发展和扩大。胸膜受累以气胸的形式在 CCPA 中很少见。我们报告了一例免疫功能低下的男性患者，有慢性咳嗽和发热史，表现为急性呼吸急促。胸部影像学显示双侧多发性空洞性结节、磨玻璃影和致密的右中叶实变和右侧气胸。支气管肺泡灌洗（BAL）显示 KOH（氢氧化钾）染色的分隔透明菌丝，真菌培养物在 BAL 和血清半乳糖甘露聚糖呈阳性，血清 IgG 为 58 MgA/L（0-40MgA/L），证实了我们患者自发性继发性气胸的病因是 CCPA。
