Fatal Massive Hemoptysis in a Patient on Low-Dose Oral Prednisone: Chronic Necrotizing Pulmonary Aspergillosis

We report a case of chronic necrotizing aspergillosis in a 74-year-old man with chronic lung disease, who was on low-dose oral prednisone. The patient was treated with various antibiotics but had no improvement. Samples obtained via bronchoscopy grew Aspergillus , and the patient was started on lipid formulation amphotericin B. Three days after admission the patient developed fatal massive hemoptysis, presumably secondary to acquired systemic-to-pulmonary vascular communication. This is an unusual presentation of a rare manifestation of pulmonary aspergillosis. A high index of suspicion is needed to diagnose this condition in susceptible patients.