Invasive Tracheobronchial Aspergillosis with Bronchial Ulcers Complicated by Nontuberculous Mycobacterial Disease

Invasive tracheobronchial aspergillosis (ITBA) complicated by nontuberculous mycobacteria (NTM) is rare. An 88-year-old man was admitted for hemoptysis. Bronchoscopy revealed bronchial ulcers, and a tissue biopsy showed Aspergillus fumigatus. He was diagnosed with ITBA, which improved with voriconaz...

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Bibliographic Details
Published in:Internal Medicine 2020/05/01, Vol.59(9), pp.1189-1194
Main Authors: Kanai, Tomohiro, Samejima, Yumiko, Noda, Yoshimi, Kim, Sung-Ho, Tamura, Kanako, Umakoshi, Taisei, Shimizu, Kazunori, Kashiwa, Yozo, Morishita, Hiroshi, Ueda, Kayo, Kawahara, Kunimitsu, Yaguchi, Takashi, Matsuoka, Hiroto
Format: Article
Language:English
Subjects:
Aspergillosis
Biopsy
bronchial ulcer
Bronchoscopy
Case Report
Etiology
Granuloma
Hemoptysis
Internal medicine
invasive tracheobronchial aspergillosis
non-tuberculous mycobacteria
Ulcers
Voriconazole
Yard waste
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Summary:Invasive tracheobronchial aspergillosis (ITBA) complicated by nontuberculous mycobacteria (NTM) is rare. An 88-year-old man was admitted for hemoptysis. Bronchoscopy revealed bronchial ulcers, and a tissue biopsy showed Aspergillus fumigatus. He was diagnosed with ITBA, which improved with voriconazole. During treatment, infiltrative shadows appeared in his lungs, and bronchoscopy was performed once again. A non-necrotic epithelioid granuloma and Mycobacterium intracellulare were detected in the biopsy specimen. He was diagnosed with NTM disease. It is important to note that tracheobronchial ulcers may cause hemoptysis and to identify the etiology and treat it appropriately when multiple bacteria are found.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.3827-19