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VOLUME 8 , ISSUE 1 ( January-June, 2019 ) > List of Articles


Pleuropulmonary Aspergillosis Presenting as Hydropneumothorax in Second Trimester Pregnancy

Selvi Chinnasamy, L. Sundararajan, Charumathi Radhakrishnan, P. Senthur Nambi

Keywords : Aspergillus fumigatus, breathlessness, hydropneumothorax, intercostal drainage, pregnancy, voriconazole

Citation Information : Chinnasamy S, Sundararajan L, Radhakrishnan C, Nambi PS. Pleuropulmonary Aspergillosis Presenting as Hydropneumothorax in Second Trimester Pregnancy. Indian J Respir Care 2019; 8 (1):57-59.

DOI: 10.4103/ijrc.ijrc_27_18

License: CC BY-NC-SA 4.0

Published Online: 05-12-2022

Copyright Statement:  Copyright © 2019; Indian Journal of Respiratory Care.


Pleuropulmonary aspergillosis is a rare entity and usually occurs in a patient with preexisting lung disease or surgery. A 29-year-old pregnant woman with 16 weeks of gestation presented with shortness of breath, right-sided chest pain, and productive cough of 2 weeks' duration. A chest radiograph done with abdominal shield revealed right hydropneumothorax. Intercostal drainage insertion was done under ultrasound guidance. Pleural fluid was exudative with high adenosine deaminase levels, and GeneXpert test was negative for Mycobacterium tuberculosis. Pleural fluid and sputum culture revealed significant growth of Aspergillus fumigatus. She was treated with voriconazole intravenously followed by oral route. The patient improved clinically with good lung expansion, and she delivered a normal live baby by elective cesarean section. We report this case in view of the rarity of pleuropulmonary aspergillosis occurring in a young pregnant female with no evidence of prior lung pathology.

  1. Latgé JP. Aspergillus fumigatus and aspergillosis. Clin Microbiol Rev 1999;12:310-50.
  2. Dagenais TR, Keller NP. Pathogenesis of Aspergillus fumigatus in invasive aspergillosis. Clin Microbiol Rev 2009;22:447-65.
  3. Romani L. Immunity to fungal infections. Nat Rev Immunol 2011;11:275-88.
  4. Buckingham SJ, Hansell DM. Aspergillus in the lung: Diverse and coincident forms. Eur Radiol 2003;13:1786-800.
  5. Karthik RK, Sudarsanam TD. An unusual cause of empyema thoracis. Indian J Med Sci 2009;63:30-2.
  6. Light RW. Pleural effusion secondary to fungal infections, actinomycosis, and nocardiosis. Pleural Disease. 4th ed., Vol. 11. Baltimore: Williams and Wilkins; 2001. p. 196-203.
  7. Herring M, Pecora D. Pleural aspergillosis: A case report. Am Surg 1976;42:300-2.
  8. Ko SC, Chen KY, Hsueh PR, Luh KT, Yang PC. Fungal empyema thoracis: An emerging clinical entity. Chest 2000;117:1672-8.
  9. Tardieu P, Dieudonne P, Monod O, Atchoarena JB. Pleural aspergilloma. J Fr Med Chir Thorac 1964;18:591-6.
  10. Krakówka P, Rowinska E, Halweg H. Infection of the pleura by Aspergillus fumigatus. Thorax 1970;25:245-53.
  11. Herbrecht R, Denning DW, Patterson TF, Bennett JE, Greene RE, Oestmann JW, et al. Voriconazole vs. amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002;347:408-15.
  12. Stern JB, Girard P, Caliandro R. Pleural diffusion of voriconazole in a patient with aspergillus fumigatus empyema thoracis. Antimicrob Agents Chemother 2004;48:1065.
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