Pulmonary Scopulariopsis in a chronic tobacco smoker

Satyavani M, Viswanathan R, Harun NS, Mathew L
Correspondence: Dr Roopa Viswanathan, ruvishy@rediffmail.com

ABSTRACT
A 70-year-old male smoker, with a three-month status of post-balloon angioplasty for ischaemic heart disease, presented with a one-week history of fever, haemoptysis and chest discomfort on coughing. The patient did not report any loss of weight or appetite. On examination, he was febrile. Pulmonary function tests revealed obstructive airway disease. High resolution computed tomography of the lungs revealed fibrosis with bronchiectasis in both the upper lobes and a spiculating subpleural mass in the posterior aspect of the right lung apex. Subsequent bronchoalveolar lavage (BAL) culture yielded the Scopulariopsis species. Our patient was treated with a four-week course of amphotericin B, followed by itraconazole. At the 24-month follow-up, the patient was asymptomatic. Subsequent BAL cultures revealed no fungal growths, and radiological studies showed a regression in the lesion.

Keywords: pulmonary, Scopulariopsis, tobacco smoker
Singapore Med J 2010; 51(8): e137-e139