부산대학교 도서관

Tracheobronchial aspergillosis accounts for a small percentage of Aspergillus-related respiratory disease and has been classified into invasive, allergic and saprophytic forms. Although this disease is generally observed in severely immunocompromised patients, it may occur in less immunocompromised or even immunocompetent patients. Herein, we report a 74-year-old woman with exertional dyspnea for 6 months. Initial chest radiograph showed right upper lobe collapse. Chest computed tomography revealed a right upper endobronchial lesion with right upper lobe collapse. Bronchoscopy showed thick mucus plugs obstructing the right upper lobe bronchial orifice, with mucosa infiltration; biopsy revealed fungal hyphae with acute angle branching and tissue necrosis, which was compatible with aspergillosis. After oral voriconazole therapy for 4 months, the chest radiograph showed no improvement. Possible causes of treatment failure are discussed.