Chronic Pulmonary Aspergillosis Misdiagnosed as Smear-Negative Pulmonary Tuberculosis in a TB Clinic in Nigeria

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Titilola Gbaja Biamila
Felix Bongomin
Nicholas Irurhe
Augustina O. Nwosu
Rita O. Oladele

Abstract

The clinical manifestations of chronic pulmonary aspergillosis (CPA) and pulmonary tuberculosis (PTB) are practically indistinguishable. We present a case of CPA in a 35-year-old HIV-negative trader, who had had three unsuccessful treatment courses for smear-negative PTB. He presented with a five-year history of recurrent symptoms suggestive of TB (haemoptysis, weight loss and productive cough). His sputum smear was acid-fast bacilli negative and GeneXpert analysis was negative for Mycobacterium tuberculosis. Chest X-rays revealed bilateral apical cavities and bullae. His Aspergillus-specific IgG tests were positive (>40 mg/L). He was managed with itraconazole 200mg twice daily with marked improvement in his clinical presentation and his quality of life after 4 months of therapy. However, he significantly deteriorated after discontinuing itraconazole for 1 month; he had adherence counselling and was re-commenced on long-term itraconazole therapy

Keywords:
Chronic pulmonary aspergillosis, smear-negative TB, itraconazole Aspergillus IgG

Article Details

How to Cite
Biamila, T., Bongomin, F., Irurhe, N., Nwosu, A. O., & Oladele, R. O. (2018). Chronic Pulmonary Aspergillosis Misdiagnosed as Smear-Negative Pulmonary Tuberculosis in a TB Clinic in Nigeria. Journal of Advances in Medicine and Medical Research, 26(10), 1-5. https://doi.org/10.9734/JAMMR/2018/41816
Section
Case Study