When COPD meets Aspergillus: A treatment Odyssey and critical insights from a 76-year-old female patient’s journey: A case report
Year: 2025
Type: article
Study design: Case Report
Abstract: RATIONALE: Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder characterized by persistent limitation of airflow. Fungal infections are not uncommon in patients with COPD. However, reports on the short-term improvement in lung function in COPD patients with IgE-negative Aspergillus tracheobronchitis (ATB) following antifungal treatment are currently rare. Here, we described a patient whose lung function significantly improved after antifungal treatment for COPD combined with ATB, along with the diagnostic process. PATIENT CONCERNS: A 76-year-old female patient with COPD presented with worsening cough, expectoration, and wheezing. Despite some relief in respiratory symptoms after empirical antibiotic and anti-inflammatory treatment, her exercise tolerance did not return to pre-illness levels. DIAGNOSES: Subsequently, a bronchoalveolar lavage fluid sample was sent for microbiological examination, which identified Aspergillus flavus (A flavus). INTERVENTIONS: The patient was treated with voriconazole for one week as antifungal therapy. OUTCOMES: The patient's subjective symptoms were further improved, and the modified British Medical Research Council dyspnea scale returned to the stable state before the exacerbation. A follow-up pulmonary function test showed an improvement of 880 mL in forced vital capacity and 620 mL in forced expiratory volume in one second. LESSONS: Treatment of acute exacerbations of COPD must emphasize careful assessment of the patient's symptoms and remain vigilant for potential coexisting ATB.
Source: Medicine
Authors: Miaomiao Chen, Guiying Chen, Song Wu, Yaqian Zhu
Institution: Tianjin Chest Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
OpenAlex ID: W4409696595