INVASIVE ASPERGILLOSIS - A LIFE-THREATENING COMPLICATION OF SHORT-TERM STEROID TREATMENT

OBJECTIVE: TO describe a patient with invasive pulmonary aspergillosis related to short-term steroid treatment. CASE SUMMARY: A 78-year-old man with chronic obstructive pulmonary disease (COPD) developed an inv asive pulmonary aspergillosis after short-term (less than 1 week) intr avenous steroid therapy, The diagnosis was established by recovering A spergillus fumigatus from a bronchoalveolar lavage and was confirmed b y autopsy, with the additional finding of an aspergilloma, DISCUSSION: This case is of interest for 3 reasons: (1) it illustrates that invas ive aspergillosis may be followed by a rapidly progressive respiratory failure, even in the absence of a fever; (2) this patient had simulta neously an aspergilloma and an invasive aspergillosis; and (3) it conf irms reports indicating that short-term steroid therapy for COPD repre sents a significant risk factor for opportunistic lung infections, CON CLUSIONS: In patients with COPD who receive even short-term steroid th erapy and who have progressive respiratory failure caused by pneumonia , invasive aspergillosis should be suspected early and acted upon acco rdingly.