CRCM  Vol.2 No.1 , March 2013
Pulmonary aspergillosis in a patient with COPD due to PEG-interferon and ribavirin therapy for chronic hepatitis C

This is a case of 52 years old male patient with chronic obstructive pulmonary disease (COPD) who developed semi-invasive pulmonary aspergillosis while on pegylated-interferon alpha-2a and for chronic hepatitis C infection. This complication is very rarely seen during interferon therapy for other any purposes. Pulmonary aspergillosis in particular group of chronic hepatitis C patients under immunosupressive therapy should also be in mind and interdisciplinary medical cooperation might be needed during the treatment for immune-suppressed patients. Pulmonary aspergillosis is also discussed from many aspects in the light of the literature.

Cite this paper
Ozdal, E. , Eser, V. , Seyhmus, G. and Nurdan, T. (2013) Pulmonary aspergillosis in a patient with COPD due to PEG-interferon and ribavirin therapy for chronic hepatitis C. Case Reports in Clinical Medicine, 2, 70-75. doi: 10.4236/crcm.2013.21020.
[1]   Falcone, M., Massetti, A.P., Russo, A., Vullo, V. and Venditti, M. (2011) Invasive aspergillosis in patients with liver disease. Medical Mycology, 49, 406-413. doi:10.3109/13693786.2010.535030

[2]   Hou, Z., Tan, D., Liu, G., Xie, Y., Li, C., Xie, J., et al. (2010) Clinical characteristics and therapeutic analysis of invasive fungal infection in chronic severe hepatitis patients. Journal of Central South University. Medical Sciences, 35, 537-542.

[3]   Fiuza, C., Salcedo, M., Clemente, G. and Tellado, J.M. (2000) In vivo neutrophil dysfunction in cirrhotic patients with advanced liver disease. The Journal of Infectious Diseases, 182, 526-533. doi:10.1086/315742

[4]   Tsiodras, S., Zafiropoulou, R., Giotakis, J., Imbrios, G., Antoniades, A. and Manesis, E.K. (2004) Deep sinus aspergillosis in a liver transplant recipient successfully treated with a combination of caspofungin and voriconazole. Transplant Infectious Disease, 6, 37-40. doi:10.1111/j.1399-3062.2004.00039.x

[5]   Paya, C.V. (2001) Prevention of fungal and hepatitis virus infections in liver transplantation. Clinical Infectious Diseases, 33, S47-S52. doi:10.1086/320904

[6]   Hoofnagle, J.H. and Seeff, L.B. (2006) Peginterferon and ribavirin for chronic hepatitis C. The New England Journal of Medicine, 355, 2444-2451. doi:10.1056/NEJMct061675

[7]   Porobcin, S., Porubcinova, I., Viraq, L., Stammova, E., Vyhankova, V. and Paralicova, Z. (2012) Invasive pulmonary aspergillosis and esophageal candidiasis in a patient with decompansated liver cirrhosis due to chronic hepatitis C and alcohol. Klinicka Microbiologie a Infeckni Lekarstvi, 18, 17-21.

[8]   Roomer, R., Hansen, B.E., Janssen, H.L. and de Knegt, R.J. (2010) Risk factors for infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C. Hepatology, 52, 1225-1231. doi:10.1002/hep.23842

[9]   Franquet, T., Müller, N.L., Giménez, A., Guembe, P., de La Torre, J. and Bagué, S. (2001) Spectrum of pulmonary aspergillosis: Histologic, clinical, and radiologic findings. Radiographics, 21, 825-837.

[10]   Cabral, F.C., Marchiori, E., Zanetti, G., Takayassu, T.C. and Mano, C.M. (2009) Semi-invasive pulmonary aspergillosis in an immunosuppressed patient: A case report. Cases Journal, 12, 40. doi:10.1186/1757-1626-2-40

[11]   Valle, J.M., González-Barcala, F.J., Alvarez-Doba?o, J.M. and Valdés, L. (2010) Invasive pulmonary aspergillosis in chronic obstructive pulmonary disease. Revista Médica de Chile, 138, 612-620.

[12]   Aquino, S.L., Kee, S.T., Warnock, M.L. and Gamsu, G. (1994) Pulmonary aspergillosis: Imaging findings with pathologic correlation. American Journal of Roentgenology, 163, 811-815. doi:10.2214/ajr.163.4.8092014

[13]   Patterson, T.F., Miniter, P., Ryan, J.L. and Andriole, V.T. (1988) Effect of immunosuppression and amphotericin B on Aspergillus antigenemia in an experimental model. The Journal of Infectious Diseases, 158, 415-422. doi:10.1093/infdis/158.2.415

[14]   Glasmacher, A., Cornely, O.A., Orlopp, K., Reuter, S., Blaschke, S., Eichel, M., et al. (2006) Caspofungin treatment in severely ill, immunocompromised patients: A case-documentation study of 118 patients. Journal of Antimicrobial Chemotherapy, 57, 127-134. doi:10.1093/jac/dki410

[15]   Ali, Z.A., Ali, A.A., Tempest, M.E. and Wiselka, M.J. (2003) Invasive pulmonary aspergillosis complicating chronic obstructive pulmonary disease in an immunocompetent patient. Postgraduate Medical Journal, 49, 7880. doi:10.4103/0022-3859.922

[16]   Kriengkauykiat, J., Ito, J.I. and Dadwal, S.S. (2011) Epidemiology and treatment approaches in management of invasive fungal infections. Journal of Clinical Epidemiology, 3, 175-191. doi:10.2147/CLEP.S12502