Case Report
A 57-year-old male patient, who applied to our clinic with complaints of
hemoptysis, was hospitalized for further examination and treatment due
to a cavitary lesion in the right upper lobe. Nine months ago, he was
treated for 55 days as non-intubation in the intensive care unit for
five days due to COVID-19 pneumonia (Figure-1). During this period,
steroid treatment and four flacons of 162 mg Tocilizumab (a monoclonal
antibody against the interleukin-6 receptor) was given because of
respiratory symptoms and sequelae COVID_19 pneumonia (Figure-2).
Pulmonary rehabilitation and steroid therapy were continued for three
months because dyspnea continued in the patient whose treatment was
terminated (Figure-3). In thorax Computed Tomography (CT), a cavitary
lesion was observed in the right upper lobe who administered with
complaints of swelling in the legs and hemoptysis in the fourth month of
his treatment (Figure-4). After taking a nonspecific culture, the
patient continued prophylactic fungal treatment and steroid treatment
due to dyspnea. Blood culture, sputum culture, urine culture, fungal
culture, and tuberculosis tests, Aspergillom specific IgE, was negative,
Total IgE was normal. On the 12th day of his treatment, the patient’s
general condition was good, and he was discharged after colchicine and
steroid treatment were arranged. In the control HRCT after antibiotic
treatment, the cavity persisted in the right upper lobe (Figure-5). Due
to intermittent complaints of hemoptysis, right upper lobectomy via
thoracotomy was performed. The postoperative pathology result was
reported as Aspergilloma (Figure-6) and discharged on the seventh
postoperative day without complications. He is in the third month of his
follow-up, and any complications occurred.
Figure-1: First hospital admission Chest X-Ray