Massive hemoptysis due to pulmonary artery pseudoaneurysm in invasive aspergillosis in a patient with interstitial lung disease and suspected Aspergillioma: A case report
Abstract
Background Invasive pulmonary aspergillosis (IPA) is a serious complication, particularly in patients with existing structural lung disease like interstitial lung disease (ILD). Angioinvasive IPA can lead to pulmonary artery pseudoaneurysm (PAP), which is a rare but life-threatening source of massive hemoptysis. Case presentation We present the case of a 78-year-old white American male with ILD (potentially from Agent Orange exposure) and chronic hypoxic respiratory failure, dependent on home oxygen, who presented with recurrent, massive hemoptysis. Computed Tomography Angiography (CTA) showed a 1.5 cm PAP in the right upper lobe cavity. Despite no classical causative immunosuppression, a diagnosis of pulmonary aspergillosis was supported by bronchoalveolar lavage (BAL) culture and galactomannan testing. Although invasive disease was suspected, the possibility of an aspergilloma with a semi-invasive component could not be excluded due to lack of prior imaging. Urgent coil embolization was performed to control the hemorrhage, followed by antifungal treatment with voriconazole. Conclusion This case underscores the need for early suspicion of pulmonary aspergillosis in ILD patients, utilizing BAL and CTA for diagnosis, and combining endovascular embolization with antifungals. Given the absence of prior imaging and underlying fibrotic lung disease, distinguishing invasive disease from semi-invasive or chronic forms can be challenging.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- In silico toxicology protocols
- In-silico strategies in nano-drug design: Bridging nanomaterials and pharmacological applications
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- mRNA codon optimization with quantum computers
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- A quantum computing implementation of nuclearelectronic orbital (NEO) theory: Toward an exact pre-Born–Oppenheimer formulation of molecular quantum systems
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.