Tuberculosis and Respiratory Diseases  2014;77(5):223-226

doi:10.4046/trd.2014.77.5.223

Aspergillus Tracheobronchitis in a Mild Immunocompromised Host.

Byung Ha CHO 1 ; Youngmin OH ; Eun Seok KANG ; Yong Joo HONG ; Hye Won JEONG ; Ok Jun LEE ; You Jin CHANG ; Kang Hyeon CHOE ; Ki Man LEE ; Jin Young AN

Affiliations

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Keywords

Aspergillosis, Allergic Bronchopulmonary; Itraconazole; ronchoscopy

Country

Republic of Korea

Language

English

Abstract

Aspergillus tracheobronchitis is a form of invasive pulmonary aspergillosis in which the Aspergillus infection is limited predominantly to the tracheobronchial tree. It occurs primarily in severely immunocompromised patients such as lung transplant recipients. Here, we report a case of Aspergillus tracheobronchitis in a 42-year-old man with diabetes mellitus, who presented with intractable cough, lack of expectoration of sputum, and chest discomfort. The patient did not respond to conventional treatment with antibiotics and antitussive agents, and he underwent bronchoscopy that showed multiple, discrete, gelatinous whitish plaques mainly involving the trachea and the left bronchus. On the basis of the bronchoscopic and microbiologic findings, we made the diagnosis of Aspergillus tracheobronchitis and initiated antifungal therapy. He showed gradual improvement in his symptoms and continued taking oral itraconazole for 6 months. Physicians should consider Aspergillus tracheobronchitis as a probable diagnosis in immunocompromised patients presenting with atypical respiratory symptoms and should try to establish a prompt diagnosis.