Chronic necrotizing pulmonary aspergillosis and ankylosing spondylarthitis

Fibro-bullous disease is a late complication of ankylosing spondylarthritis . Its radiologic features frequently mimics tuberculosis or excavated neopl asm. About 50 to 65% of patients with ankylosing spondylarthritis have chro nic aspergillus colonization of their airways. Pulmonary aspergillosis infe ction occurs in 10 to 30% during evolution. We report two cases of patients with spondylarthritis who developed chronic necrotizing pulmonary aspergillosis. Diagnosis was based on serology, mycologic examination of expectoration and in one case on histology obtain by transbronchial biopsies. Pulmonary complications due to aspergillus species frequently reveal an ass ociated fibro-bullous disease in patients with ankylosing spondylarthritis. This carl be reported to diminished chest wall movements in such patients. Treatment is based on administration of anti-fungal drugs. In case of medic al treatement failure, thoracic surgery may be indicated.