Abstract
This is a case of 52 years old male patient with chronic obstructive pulmonary disease (COPD) who developed semi-invasive pulmonary aspergillosis while on pegylated-interferon alpha-2a and for chronic hepatitis C infection. This complication is very rarely seen during interferon therapy for other any purposes. Pulmonary aspergillosis in particular group of chronic hepatitis C patients under immunosupressive therapy should also be in mind and interdisciplinary medical cooperation might be needed during the treatment for immune-suppressed patients. Pulmonary aspergillosis is also discussed from many aspects in the light of the literature.
Highlights
This is a case of 52 years old male patient with chronic obstructive pulmonary disease (COPD) who developed semi-invasive pulmonary aspergillosis while on pegylated-interferon alpha-2a and ribavirin for chronic hepatitis C infection
A new case of combined fungal infection in a patient with decompansated cirrhosis has been recently published, up to the literature review, this is the first case of pulmonary aspergilosis in a hepatitis C patient treated with pegylated interferon (PEG-IFN) and ribavirin (RBV)
Our patient has been taking the anti-viral therapy for the last 4 months when his symptoms; cough, fever, general status deterioration had first appeared. He first went to local hospital despite the presence of all these mentioned predisposing factors, patient was not considered by the physician as a patient at risk for important fungal infection because of negative HCV- RNA level and normal hemoglobin and neutrophil levels at the end of 3rd month control and considered as bacterial pulmonary infection and was prescribed an empiric antibiotic without cessating PEG-IFN/RBV and performing further evaluations, and this leaded to a lack and delay in diagnosis of pulmonary aspergilosis
Summary
This is a case of 52 years old male patient with chronic obstructive pulmonary disease (COPD) who developed semi-invasive pulmonary aspergillosis while on pegylated-interferon alpha-2a and ribavirin for chronic hepatitis C infection. At the 18th week of therapy the patient complained about progressive fatigue, nausea and being unable to walk along with weight loss of more than 10 kg in one month He was referred to our clinic from his local hospital, in a lethargic appearance with intensive productive cough. His subsequent control visit 2 weeks after discharge showed normal blood tests and improved radiological appearance (Figure 2) and general status without any pulmonary symptoms. He is still on close follow-up and HCV-RNA level is still being negative for 18 months after the cessation of the anti-viral treatment
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