Acute exacerbation of idiopathic pulmonary fibrosis triggered by Aspergillus empyema

Atsushi Suzuki; Tomoki Kimura; Kensuke Kataoka; Toshiaki Matsuda; Toshiki Yokoyama; Yuta Mori; Yasuhiro Kondoh

doi:10.1016/j.rmcr.2018.01.004

Acute exacerbation of idiopathic pulmonary fibrosis triggered by Aspergillus empyema

Respir Med Case Rep. 2018 Jan 31:23:103-106. doi: 10.1016/j.rmcr.2018.01.004. eCollection 2018.

Authors

Atsushi Suzuki^{1

2}, Tomoki Kimura¹, Kensuke Kataoka¹, Toshiaki Matsuda¹, Toshiki Yokoyama¹, Yuta Mori¹, Yasuhiro Kondoh¹

Affiliations

¹ Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan.
² Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

Abstract

Acute exacerbation (AE) is a severe and life-threatening complication of idiopathic pulmonary fibrosis (IPF). In 2016, the definition and diagnostic criteria for AE-IPF were updated by an international working group. The new definition includes any acute, clinically significant respiratory deterioration (both idiopathic and triggered events) characterized by evidence of new widespread alveolar abnormality in patients with IPF. There are no currently proven beneficial management strategies for idiopathic and triggered AE-IPF. This is the first report describing AE-IPF triggered by Aspergillus empyema, which was improved by a combination of corticosteroid, systemic antifungal therapy, local antifungal therapy, and additional pharmacological therapies. Future research may reveal optimal strategies for both idiopathic and triggered AE-IPF.

Keywords: AE, acute exacerbation; AE-IPF; AMPH-B, amphotericin-B; Acute exacerbation; Aspergillus infection; CRP, C-reactive protein; CT, computed tomography; ILD, interstitial lung disease; IPF, idiopathic pulmonary fibrosis; Idiopathic pulmonary fibrosis; Triggered AE; VRCZ, voriconazole; WBC, white blood cell; rhTM, recombinant human soluble thrombomodulin.

Publication types

Case Reports