case_images: PMC11811237_01
case_images: The index presented with bloody sputum at age 22 when her chest CT was consistent with chronic pulmonary aspergillosis (A, B). Histology of the lung lesion was consistent with aspergillosis and displayed high numbers of eosinophils (C-E). Seven years later, hemoptysis recurred, and chest CT showed a new aspergillosis lesion (F, G) which was surgically removed (H). One year later, the CT scan appeared unremarkable (I). Soon after, several new aspergillosis lesions were found (J, K) leading to surgical removal of the largest lesions. Medications (vori, voriconazole; posaconazole; isavuconazole; Ambisome, liposomal amphotericin B; IgG, intravenous IgG substitution) are indicated. Blue solid arrows on the timeline indicate the surgical operations
case_images: 10875_2025_1867_Fig1_HTML.jpg
case_images: PMC11811237_01_10875_2025_1867_Fig1_HTML.jpg
case_images: Fig1
case_images: Computed tomography (CT) demonstrated a cavity with a rounded mass in the left lung upper lobe (Fig. 1A-B). The necrotic tissue samples were positive for Aspergillus fumigatus (Fig. 1C-E) and abundant eosinophils. Again, CT scan revealed left upper lobe lesion suggestive of aspergillosis (Fig. 1F-G). The lesion was surgically removed (Fig. 1H). She received voriconazole followed by oral posaconazole for one year at which point her chest CT was unremarkable (Fig. 1I). Soon after, additional multiple solid lesions were observed in her lung CT (Fig. 1J-K) leading to the need of another surgical treatment.