Abstract
When filling defects are found on CTA, they are almost universally assumed to be emboli from a peripheral deep vein thrombosis. However, new studies have led to the theory that localized inflammation, endothelial cell damage, and disruption of blood flow cause de novo formation of clots within the pulmonary artery or in situ thrombosis. Fungal origin of pulmonary embolism is rare. We report the case of a 31-year-old man previously treated for tuberculosis. He was admitted with haemoptysis and a chest CT scan revealed an obstruction of the right upper pulmonary artery. He was initially diagnosed as a pulmonary embolism of cruoric origin and anticoagulant treatment was given. But the patient had massive hemoptysis a few days later. Aspergillosis serology was positive and the diagnosis of pulmonary aspergillosis complicated by pulmonary embolism in situ was retained. Antifungal treatment was started with good improvement and cessation of the haemoptysis.
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