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Pleural Aspergillosis with Bronchopleurocutaneous Fistula and Costal Bone Destruction: A Case Report

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Abstract

A 65-year-old man who, when young, had had tuberculosis treated by therapeutic pneumothorax, consulted his family physician for a constitutional syndrome and dyspnea. At this time radiologic studies showed left pleural effusion with bilateral calcified plaques, an infiltrate in the upper left lobe, and a picture compatible with aspergilloma, all suggesting semi-invasive aspergillosis. The patient failed to show up for his followup visit, so no therapy could be started or further diagnostic tests ordered. One month later he was admitted to this hospital for a bronchopleural fistula (empyema necessitatis) with subsequent spontaneous hydropneumothorax and costal bone involvement. The patient underwent surgery because of his rapid worsening condition. Biopsy examination revealed a large pleural aspergilloma. Despite immediate antifungal therapy, the patient died. We believe this to be the first report of pleural Aspergillus with a bronchopleurocutaneous fistula and costal bone destruction.

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Acknowledgments

The authors thank lan Johnstone for help with the English language version of the text.

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Authors and Affiliations

  1. Pneumology Service, Carlos Haya Hospital, Malaga, Spain

    Enrique J. Soto-Hurtado

  2. Faculty of Medicine, Malaga University, Malaga, Spain

    Ester Marín-Gámez

  3. Family and Community Medicine Service, Carlos Haya Hospital, Malaga, Spain

    Nuria Segura-Domínguez

  4. Internal Medicine Service, Carlos Haya Hospital, Malaga, Spain

    Francisco Jiménez-Oñate

Authors
  1. Enrique J. Soto-Hurtado
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  2. Ester Marín-Gámez
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  3. Nuria Segura-Domínguez
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  4. Francisco Jiménez-Oñate
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Correspondence to Enrique J. Soto-Hurtado.

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Soto-Hurtado, E.J., Marín-Gámez, E., Segura-Domínguez, N. et al. Pleural Aspergillosis with Bronchopleurocutaneous Fistula and Costal Bone Destruction: A Case Report. Lung 183, 417–423 (2005). https://doi.org/10.1007/s00408-005-2553-4

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  • DOI: https://doi.org/10.1007/s00408-005-2553-4

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