Spontaneous pleural aspergillosis in an immunocompetent young adult treated with minimally invasive surgery

Hiromi Ichikawa; Ryoichiro Doi; Keitaro Matsumoto; Koichi Tomoshige; Masataka Hirabaru; Ryusuke Machino; Tomohiro Obata; Satoshi Mizoguchi; Junji Irie; Tomoshi Tsuchiya; Takeshi Nagayasu

doi:10.1016/j.rmcr.2023.101869

Spontaneous pleural aspergillosis in an immunocompetent young adult treated with minimally invasive surgery

Respir Med Case Rep. 2023 May 11:44:101869. doi: 10.1016/j.rmcr.2023.101869. eCollection 2023.

Affiliations

¹ Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan.
² Department of Respiratory Surgery, Nagasaki Harbor Medical Center, Shinchi-machi 6-39, Nagasaki, 850-0842, Japan.
³ Department of Pathology, Nagasaki Harbor Medical Center, Shinchi-machi 6-39, Nagasaki, 850-0842, Japan.
⁴ Department of Thoracic General Surgery, Toyama University Hospital, Sugitani 2630, Toyama, 930-0194, Japan.

Abstract

Spontaneous cases of pleural aspergillosis in healthy adults are rare, and the optimal therapeutic approach has not been established. Here we report a rare case of spontaneous pleural aspergillosis in an otherwise healthy young adult. Two-stage surgery with decortication and cavernostomy, followed by systemic antifungal therapy, finally resulted in a successful resolution of his empyema without any serious complications. In young patients with good pulmonary compliance, less invasive procedures, such as thoracoscopic decortication and/or carvernotomy, is a potential treatment option.

Keywords: Aspergillus empyema; Cavernostomy; Decortication; Minimally invasive surgery; Pleural aspergillosis; Spontaneous pneumothorax.

Publication types

Case Reports