Pulmonary Alveolar Proteinosis Exacerbated by Aspergilloma

Abstract

Background. Pulmonary alveolar proteinosis is a rare disease, involving bacterial and fungal infection. It was reported that some cases of pulmonary alveolar proteinosis might have an unfavorable outcome because of these infections. Case. A 52-year-old man who had been treated for pulmonary alveolar proteinosis in another hospital, was referred to our hospital, complaining of bloody sputum in March 2001. Chest X-ray films showed a nodular shadow in the right upper lung field and bilateral infiltrates in the middle and lower lung fields. Chest computed tomography showed that a nodular shadow had a cavity in the right upper lobe in November, 2001. Diagnosis of aspergilloma was made by the clinical course and the pathological findings of transbronchial biopsy specimens. In spite of treatment with oral itraconazole, the fungus ball increased remarkably. At the same time, an exacerbation of pulmonary alveolar proteinosis was suspected. Conclusion. We considered that an exacerbation of aspergilloma might have exacerbated the pulmonary alveolar proteinosis.