A Case of Invasive Pulmonary Aspergillosis Resulted from the Treatment of Chronic Eczema

Authors

  • Mi mi zhou No.1 Department of Geriatrics, Hangzhou Wenzhong Hospital, Hangzhou, 310000, China
  • Jianbo Hong No.1 Department of Geriatrics, Hangzhou Wenzhong Hospital, Hangzhou, 310000, China
  • Yue Chen No.1 Department of Geriatrics, Hangzhou Wenzhong Hospital, Hangzhou, 310000, China

DOI:

https://doi.org/10.30564/jgm.v4i2.4965

Abstract

This was an advanced male (87-year-old) with refractory chronic eczema for over 40 years, based on his allergic constitution, accompanied with chronic kidney disease due to primary hypertension (CKD, phase 3). It was so diffi cult to tolerate the severe itching that the glucocorticoids (GC) had to be applied to it, but some new-onset respiratory symptoms, such as cough, dyspnea after exertion etc., occurred to this patient. Some classical IPA images were found on his pulmonary CT scanning, which were further comfirmed by the positive findings of GM-test, and then a final diagnosis of IPA was accordingly established. Unfortunately, a persistent fever emerged after starting an antifungal therapy to the patient, and his IL-2 level was detected to be superhigh. As a response to allergic fever, GC was carefully given intravenously again to treat it, and it turned out to be totally improved since then; suggesting that systemic thinking (integrated with the other clinical evidences) is essential to diagnose IPA, and GC can also be used to improve its symptoms with the existence of antifungal therapy.

Keywords:

Chronic eczema; Glucocorticoids; Invasive pulmonary aspergillosis; Allergic fever; Antifungal therapy

References

[1] Kirti, G., Ashim, D., Kusum, J., et al., 2010. Aspergillus endocarditis in a known case of allergic bronchopulmonary aspergillosis: an autopsy report. Cardiovascular Pathology. 19, 137-139.

[2] Limper, A.H., Knox, K.S., Sarosi, G.A., et al., 2011. American Thoracic Society Fungal Working Group. An official American thoracic society statement: treatment of fungal infections in adult pulmonary and critical care patients. American Journal of Respiratory and Critical Care Medicine. 183, 96-128.

[3] Walsh, T.J., Anaissie, E.J., Denning, D.W., et al., 2008. Treatment of aspergillosis: clinical practice guildlines of Infectious Diseases Society of America. Clinical Infectious Diseases. 46, 327-360.

[4] Pfeiffer, C.D., Fine, J.P., Safdar, N., 2006. Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. Clinical Infectious Diseases. 42, 1417-1427.

[5] Agarwal, R., 2009. Allergic bronchopulmonary aspergillosis. Chest. 135, 805-826.

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How to Cite

zhou, M. mi, Hong, J., & Chen, Y. (2022). A Case of Invasive Pulmonary Aspergillosis Resulted from the Treatment of Chronic Eczema. Journal of Geriatric Medicine, 4(2), 3. https://doi.org/10.30564/jgm.v4i2.4965

Issue

Article Type

Case Report