Membranous Tracheobronchitis caused by Aspergillus in a Lung Transplanted Patient: Case Report

A form of aspergillus involvement of respiratory system is aspergillus tracheobronchitis which is mainly seen in HIV positive or lung transplanted patients.This disease can result in a thick membrane caused by aspergillus and necrotic materials.The treatment is with amphotericin B or itraconazole. In cases with thick and large membrane, it is usually necessary to remove the membrane with a rigid bronchoscope. A 60-year old man who underwent right lung transplantation as the result of pulmonary emphysema developed cough and dyspnea 3 weeks after the operation. In bronchoscopy, mucosal inflammation and a white thick membrane were noted in the right intermedius bronchus. In biopsy of the membrane, aspergillar hypha and fibrinoleuckocytic exudates were observed. The patient underwent treatment with Itraconazole and membrane debridement. The symptoms were all vanished and there were no complications in the bronchus in the later bronchoscopies except the minimal scarring at the site of lesion. (Tanaffos 2005; 4(13): 71-75)