Fatal Invasive Pulmonary Aspergillosis Associated with Nonspecific Interstitial Pneumonia: An Autopsy Case Report

Intern Med. 2018;57(24):3619-3624. doi: 10.2169/internalmedicine.1144-18. Epub 2018 Dec 15.

Abstract

Invasive pulmonary aspergillosis (IPA) usually occurs in patients with severe immunodeficiencies involving neutropenia. Underlying lung disease is a well-known risk factor of IPA; however, interstitial lung disease has not been recognized as a risk factor of IPA. We herein report a patient with fibrotic nonspecific interstitial pneumonia who experienced IPA without neutropenia. His IPA was fatal and showed unusually slow disease progression over one month. The computed tomography findings showed only nonspecific consolidation and no typical lesions suggestive of IPA. Finally, the autoptic findings revealed numerous Aspergillus fungi, neutrophilic pulmonary necrosis, and vessels invaded by Aspergillus fungi.

Keywords: autopsy; cyclosporine A; immunocompetent; invasive pulmonary aspergillosis; nonspecific interstitial pneumonia; prednisolone.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autopsy
  • Fatal Outcome
  • Humans
  • Invasive Pulmonary Aspergillosis / complications*
  • Invasive Pulmonary Aspergillosis / diagnostic imaging
  • Invasive Pulmonary Aspergillosis / pathology
  • Lung Diseases, Interstitial / complications*
  • Male
  • Neutropenia
  • Risk Factors
  • Tomography, X-Ray Computed