A 45-year-old man worked in quarries for 15 years.
She was diagnosed with complicated silicosis in PFMS.
Ex-smoker for two years, 25 packs/year.
Pulmonary tuberculosis in 2007.
He came to the Emergency Department in March 2009 with threatening hemoptysis, preceded by cough and brownish sputum of 4 weeks of evolution.
Physical examination revealed vital signs within normal limits and bilateral snoring on pulmonary auscultation.
Blood tests revealed leukocytosis (11,280 cells/μl with 80% neutrophils) with no other abnormalities.
Fiberoptic bronchoscopy revealed a large clot in the right upper lobe bronchus.
CT showed diffuse bilateral micronodular interstitial involvement, some calcified nodules with predominance in upper lobes and clusters that had increased compared to previous studies, with appearance of nodular and diffuse pleural material.
The culture was positive for Aspergillus fumigatus in sputum and bronchial aspirate.
The IgG precipitins were positive in blood and the bronchial antigen was negative.
Bronchial artery embolization of the LSI was performed with control of hemoptysis. Voriconazole was started with good evolution after one year of treatment with negativization of serum precipitins.
