A Case of Invasive Pulmonary Aspergillosis Resulted from the Treatment of Chronic Eczema

Abstract

This was an advanced male (87-year-old) with refractory chronic eczema for over 40 years, based on his allergic constitution, accompanied with chronic kidney disease due to primary hypertension (CKD, phase 3). It was so diffi cult to tolerate the severe itching that the glucocorticoids (GC) had to be applied to it, but some new-onset respiratory symptoms, such as cough, dyspnea after exertion etc., occurred to this patient. Some classical IPA images were found on his pulmonary CT scanning, which were further comfirmed by the positive findings of GM-test, and then a final diagnosis of IPA was accordingly established. Unfortunately, a persistent fever emerged after starting an antifungal therapy to the patient, and his IL-2 level was detected to be superhigh. As a response to allergic fever, GC was carefully given intravenously again to treat it, and it turned out to be totally improved since then; suggesting that systemic thinking (integrated with the other clinical evidences) is essential to diagnose IPA, and GC can also be used to improve its symptoms with the existence of antifungal therapy.