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Unusual case of chronic cavitary pulmonary aspergillosis presenting as spontaneous pneumothorax in an immunocompromised man
  1. Swasthi S Kumar1,
  2. Animesh Ray1,
  3. Naval Kishore Vikram1 and
  4. Surabhi Vyas2
  1. 1Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Radiology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Animesh Ray; doctoranimeshray{at}


Chronic cavitary pulmonary aspergillosis (CCPA) is a slow destructive type of chronic pulmonary aspergillosis, characterised by multiple pulmonary cavities that develop and expand over several months or years. Pleural involvement in the form of pneumothorax has been rarely reported in CCPA. We report such an unusual case of an immunocompromised male, with a history of chronic cough and fever, presenting with acute onset of shortness of breath. Chest imaging showed bilateral multiple cavitating nodules, ground glass opacities and dense right middle lobe consolidations and right-sided pneumothorax. Bronchoalveolar lavage (BAL) showed septate hyaline hyphae on KOH (potassium hydroxide) staining and fungal culture grew Aspergillus fumigatus. BAL and serum galactomanan were positive and serum IgG for A. fumigatus was 58 MgA/L (0–40MgA/L) confirming the cause of spontaneous secondary pneumothorax in our patient as CCPA.

  • infections
  • respiratory medicine
  • general practice / family medicine

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  • Contributors SSK prepared the manuscript. AR, NKV reviewed and edited the manuscript. SV prepared the images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.