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