Behçet's disease with invasive pulmonary aspergillosis and Aspergillus auriculatus infection: A case report

Abstract

Rationale:Behçet's disease (BD) is an inflammatory disease that leads to multisystemic immune dysfunction and that involves pulmonary system alterations.Patient concerns:A 26-year-old woman presented with dull right chest pain for 30 days and intermittent cough with expectoration for 5 days. She had a history of recurrent oral ulcer and constitutional rash 2 months prior.Diagnoses:The patient was diagnosed with BD complicated by IPA and Aspergillus auriculatus infection.Interventions:The patient was administered itraconazole oral solution (200mg b.i.d) to treat the fungal infection. After a diagnosis of BD was made, she received 40mg of methylprednisolone sodium succinate daily for 1 week.Then, she also received 24mg of methylprednisolone sodium succinate daily, which was decreased by 2mg per half month, until the rash had resolved. The patient continued to receive 200mg Q. D itraconazole orally for 3 months. Thereafter, itraconazole was stopped, while daily oral administration of 10mg of methylprednisolone sodium succinate was continued.Outcomes:The rash was observed to resolve, and CT revealed that the lesions in both the right and left lung were reduced. During a telephone follow-up performed after 6 months, the patient stated that no symptoms had recurred during the follow-up period.Lessons:This case illustrates that for patients with BD, ignoring extrapulmonary symptoms often leads to a delayed diagnosis. Physicians should perform a thorough medical history and physical examination of these patients, as the information obtained in this manner may provide important clues for disease diagnosis and treatment.