Pulmonary mycobacteriosis caused by mycobacterium kansasii as a precede to the chronic pulmonary aspergillosis: case report

Sa？etak Aim: To present a patient suffering from chronic pulmonary aspergillosis and in whom a prolonged use of corticosteroids due to chronic obstructive pulmonary disease represented a serious risk factor in the development and progression of the infection. Case report: We present a case of a 52-year-old cachectic, HIV seronegative potator and smoker who, having recovered from pulmonary mycobacteriosis caused by Mycobacterium kansasii, developed a chronic cavitary pulmonary aspergillosis (CCPA) which was confirmed by radiological, microbiological (positive culture findings on Aspergillus fumigatus in sputum samples, bronchial aspirate and bronchoalveolar lavage) and blood findings (IgG antibodies and a positive galactomannan antigen for Aspergillus).Granulomatous reaction without a hyphal invasion was confirmed by transbronchial lung biopsy. Despite being treated with peroral and intravenous antifungal medicines, the patient died, most probably due to the development of a more invasive form of pulmonary aspergillosis. Conclusion: Due to the lack of unambiguous diagnostic and therapeutic criteria, chronic pulmonary aspergillosis poses a considerable challenge to the clinician, because it is the case of a continuous disease which shows different forms of clinical and radiological presentation in its evolution. Its relatively high morbidity and mortality rate , despite targeted antifungal therapy, proves the need for further researches, particularly those which refers to the identification of certain presentations of the disease and efficacy of therapeutic methods