A Fatal Case of Aspergillus Empyema

Year 2019, , 91 - 92, 01.01.2019

Ya-fang Wu Chien-ming Chao

https://doi.org/10.5455/umj.20190718071352

Abstract

We described a fatal case of Aspergillus empyema in a patient with COPD. Although Aspergillus empyema is extremely rare,1-3 this clinical entity is associated with high morbidity and mortality. As the previous investigation,4 corticosteroids in our case play a critical role in increasing susceptibility to Aspergillus infection. Because the cases number is limited, the appropriate treatments, such as systemic antifungal agent, local administration of an antifungal agent, and surgical intervention still need a further large study to investigate its efficacy. In conclusion, clinicians should keep in mind the possibility of Aspergillus empyema in the patients receiving corticosteroid. Early diagnosis and prompt treatment may save a life.

Keywords

Aspergillus empyema

References

• Goel, M.K., Juneja, D., Jain, S.K., Chaudhuri, S., and Kumar, A. A rare presentation of aspergillus infection as empyema thoracis. Lung India. 2010; 27: 27–29
• Lee HW, Kim YW, Cho J, Lee CH. Empyema necessitatis due to Aspergillus fumigatus. BMJ Case Rep. 2014 Dec 1;2014. pii: bcr2014206047. doi: 10.1136/bcr-2014-206047.
• Matsuda T, Koreeda Y, Mataki H, Taira T, Noma S, Higashimoto I. A case of Aspergillus empyema successfully treated with combination therapy of voriconazole and micafungin: excellent penetration of voriconazole and micafungin into pleural fluid.Intern Med.2010;49(12):1163-9
• Schaffner A. Therapeutic concentrations of glucocorticoids suppress the antimicrobial activity of human macrophages without impairing their responsiveness to gamma interferon. J Clin Invest 1985; 76: 1755-1764.