Successful Treatment of Invasive Pulmonary Aspergillosis Using a New Antifungal Agent (Caspofungin) in an Immunocompetent Patient with Chronic Obstructive Pulmonary Disease-A Case Report

Abstract

Immunocompromised individuals are susceptible to pulmonary aspergillus infection, but invasive aspergillus infection is rarely seen in the presence of normal immunity. Some reports have described invasive pulmonary aspergillosis (IPA) occurring in chronic obstructive pulmonary disease (COPD) patients receiving corticosteroid treatment. We report a 74-yearold male patient with COPD who was treated regularly with inhaled corticosteroids. He presented with fever, productive cough and exacerbation of dyspnea accompanied with chest radiographic abnormalities on admission. IPA was diagnosed soon thereafter by bronchoscopy with bronchial biopsy and bronchoalveolar lavage (BAL). A new antifungal agent (caspofungin) was used which successfully treated the disease within 14 days. In summary, since patients with underlying COPD and corticosteroids use are predisposed to IPA, physicians should consider such an infection, and bronchoscopy may be helpful in the early diagnosis. Echinocandins, such as caspofungin, are effective in the treatment of IPA.