DOI: https://doi.org/10.36347/sjmcr.2026.v14i11.034

Pages: 2558-2561

Background: Invasive pulmonary aspergillosis (IPA) is a severe fungal infection associated with substantial mortality, particularly in patients with impaired immune defenses. Early diagnosis and appropriate antifungal treatment are essential to improve outcomes. Case presentation: We report the case of a 39-year-old male chronic smoker receiving long-term corticosteroid therapy who presented with progressive respiratory distress and respiratory muscle weakness. At admission, his respiratory rate was 35 breaths/min, and oxygen saturation was 99% while receiving high-flow oxygen. Thoracic computed tomography (CT) showed a halo sign, described as an area of ground-glass opacity. Bronchoscopy was performed, and bronchoalveolar lavage (BAL) fluid was submitted for mycological examination. Direct microscopy revealed septate fungal hyphae with acute-angle branching, and culture findings were compatible with Aspergillus fumigatus. The organism was identified before voriconazole was initiated. Testing for Pneumocystis jirovecii was negative. Serum galactomannan testing was positive. The patient died, with the death attributed clinically to pulmonary aspergillosis according to the available information. Histopathological confirmation and detailed antifungal treatment information were unavailable. Conclusion: This case highlights the severity of pulmonary aspergillosis and the importance of early mycological investigations in patients presenting with severe respiratory deterioration. The integration of microbiological, clinical, and radiological findings is essential to support the diagnosis and guide management.