Pulmonary Aspergillosis Complicated by Recurrent Pneumothorax in a Healthy Nigerian Adolescent at Cedar Crest Hospital, Abuja: A Diagnostic Conundrum (Case Report)

West Afr J Med. 2025 January; 42 (1): 73-76 PMID: 40548510

Abstract

Pulmonary Aspergillosis and recurrent pneumothorax are rare paediatrics conditions posing a diagnostic difficulty when presenting together in a patient. We report the case of a male Nigerian adolescent presenting with features of community acquired pneumonia (CAP) and recurrent pneumothoraces. He had several courses of empirical antibiotics indicated for CAP with partial evidence of improvement and underwater seal drainage chest tube, for the pneumothorax severally. The pneumothorax resolved after each course of antibiotics but re-occurred after removal of closed tube thoracotomy drainage (CTTD). A galactomannan antigen test done, after six weeks of admission was positive for Aspergillus. Administration of Voriconazole, was associated with resolution of the lung opacities and recurrent pneumothorax. The diagnostic conundrum is discussed with a view to increase disease awareness among physicians working in similar resource limited setting and improve similar case management.