Pleural aspergillosis in a patient with recurrent spontaneous pneumothorax: The challenge of an optimal therapeutic approach

Isabel Abreu; Mariana Guedes; Raquel Duro; Sara Lopes; João Maciel; Lurdes Santos

doi:10.1016/j.mmcr.2020.02.004

Pleural aspergillosis in a patient with recurrent spontaneous pneumothorax: The challenge of an optimal therapeutic approach

Med Mycol Case Rep. 2020 Feb 24:28:4-7. doi: 10.1016/j.mmcr.2020.02.004. eCollection 2020 Jun.

Authors

Isabel Abreu¹, Mariana Guedes¹, Raquel Duro¹, Sara Lopes², João Maciel², Lurdes Santos¹

Affiliations

¹ Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Oporto, 4200-319, Portugal.
² Cardiothoracic Surgery Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Oporto, 4200-319, Portugal.

Abstract

Pleural aspergillosis (PA) is a rare but potentially fatal disease. Most cases are secondary to bronchopleural fistulae or pleural intervention and can occur in the absence of immunosuppression. We report a case of PA in a young patient after pleurodesis for recurrent pneumothorax. Clinical resolution was achieved with systemic and local antifungal therapy combined with surgical debridement. Hepatotoxicity led to a switch from voriconazole to isavuconazole, with a successful outcome.

Keywords: Hepatotoxicity; Isavuconazole; Pleural aspergillosis; Pleural instillation; Recurrent pneumothorax.

Publication types

Case Reports