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A Case of Endobronchial Aspergilloma Presenting as Obstructive Pneumonia in Immunocompetent Patient without Underlying Lung Disease
민경훈 , 최종현 , 심재겸 , 오지연 , 이은정 , 이승현 , 이승헌 , 이은주 , 허규영 , 이승룡 , 이상엽 , 김제형 , 신철 , 심재정 , 인광호 , 강경호
UCI I410-ECN-0102-2014-500-002059156
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Aspergillus spp. is a ubiquitous fungus and responsible for a broad spectrum of lung disease, depending on the patient`s immune status and underlying lung disease. Pulmonary involvement of aspergillosis is usually classified with a pulmonary as-pergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing pulmonary aspergillosis, and invasive aspergillosis. Aspergilloma, the most common form of Aspergillus infection, occurs in immunocompetent patients with prior pulmonary structural diseases such as tuberculosis, sarcoidosis, histoplasmosis, bronchiectasis or emphysema. An endobronchial aspergillo-ma is a rare presentation of pulmonary aspergillosis and is usually incidentally found in immunocompetent patients with under-lying lung disease. We report a case of endobronchial aspergilloma presenting as obstructive pneumonia in immunocompetent patient without underlying lung disease. A 70-year-old woman was admitted to our hospital complaining of fever and chills. She did not have any history of medical disease, especially pulmonary disease. Chest X-ray and chest computed tomography suggested obstrurctive pneumonia on inferior lingular segment of left upper lung. The bronchoscopy showed near total ob-struction of left upper inferior lingular segmental bronchus due to small whitish mass. The mass obstructing the airway was removed using grasping forceps and it was diagnosed pathologically as endobronchial aspergillosis. She showed symptomatic and radiographic improvement after removal of the mass and antibiotic therapy.

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