Open AccessDifferential diagnosis of infections in a patient with Chronic Obstructive Pulmonary Disease
Author(s) -
Paolo Ghiringhelli
Publication year - 2008
Publication title -
clinical management issues
Language(s) - English
Resource type - Journals
eISSN - 2283-3137
pISSN - 1973-4832
DOI - 10.7175/cmi.v2i4.564
Subject(s) - medicine , leukocytosis , copd , differential diagnosis , itraconazole , pulmonary disease , aspergillus fumigatus , respiratory system , lung , disease , productive cough , antibiotics , intensive care medicine , dermatology , pathology , immunology , antifungal , microbiology and biotechnology , biology
We describe a case of a 65-years-old patient with Chronic Obstructive Pulmonary Disease (COPD), receiving oxygen therapy and resistant to antibiotic therapy. He was admitted with high fever, productive cough, marked leukocytosis, and chest X-ray findings of infiltration and fluid levels within lung cysts. A differential diagnosis was essential to start an adequate treatment and avoid the rapid worsening of patients respiratory status. In patients with chronic pulmonary diseases under immunotherapy, micotic infections should be considered. Aspergillus fumigatus was cultured from bronchial washing fluid and we diagnosed chronic necrotizing pulmonary aspergillosis (CNPA). Oral itraconazole was started and his symptoms and laboratory data markedly improved