Un cas rare d’aspergillome volumineux développé au sein d’une lésion de fibrose pulmonaire secondaire à une sclérodermie systémique chez une malade immunocompétente à Madagascar

Autor: R. E. Raherison, R. F. Rapelanoro, J. R. Rakotomizao, J. L. Rakotoson, H. R. Rajaona, H. M. D. Vololontiana, R. Andrianasolo, A.C.F. Andrianarisoa, M. J. D. Randria
Rok vydání: 2011
Předmět:
Zdroj: Bulletin de la Société de pathologie exotique. 104:325-328
ISSN: 1961-9049
0037-9085
DOI: 10.1007/s13149-011-0141-9
Popis: We report a rare case of a huge aspergilloma developed within a bronchiectasis due to pulling by a pulmonary fibrosis of systemic scleroderma. The patient is a 58-year-old woman presenting a deterioration of the general state associated with repeating hemoptysis, dyspnea, dysphagia, sclerodactylia, generalized cutaneous sclerosis and Raynaud's phenomenon. There was no antecedent pulmonary tuberculosis. The patient had a pulmonary arterial hypertension complicated by a chronic pulmonary heart at the stage of right cardiac decompensation. Aspergillosis serology was positive and the immunological assessment confirmed scleroderma. The computed tomography showed a huge oblong opacity in a small round bell shape ("signe du grelot", Monad's sign) in the left upper lobe developed within a bronchiectasis, and a bilateral pulmonary fibrosis. Although surgery remains the recommended treatment of an aspergilloma, the management of our patient was medical in front of contra-indication for surgery. The evolution was marked by repeating hemoptysis and stability of the pulmonary lesions 2 years later. The management of this entity remains difficult and complicated; the prognosis is in general unfavourable and depends at the same time on the evolution of scleroderma and the aspergilloma infection.
Databáze: OpenAIRE
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