Pulmonary aspergillosis is a life-threatening condition, especially for individuals with predisposing factors such as prior tuberculosis, smoking, and immune impairment. This case report describes the management of a 33-year-old male with a history of cured tuberculosis and active pulmonary aspergillosis who developed hemorrhagic shock following severe hemoptysis. Initial management included blood transfusion and the administration of tranexamic acid. Surgical prehabilitation was performed, and the patient underwent bilobectomy. Post-surgery, the patient developed respiratory failure due to a bronchopleural fistula, which was surgically repaired. The patient was managed in the intensive care unit (ICU) and subsequently discharged in good health. This case highlights the complexity of managing severe hemoptysis and its complications, and the importance of early multidisciplinary intervention and preoperative optimization.
Keywords: bronchopleural fistula; hemoptysis; peri-operative medicine; pulmonary aspergillosis; thoracic anesthesia.
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