Necrotizing pulmonary aspergillosis: Regarding two clinical cases [Aspergilose pulmonar necrotizante: A propósito de dois casos clínicos]

The authors present two case reports of necrotizing pulmonary aspergillosis. this disease is part of a spectrum of clinical conditions caused by the inhalation of aspergillus spores. the necrotizing pulmonary aspergillosis (npa) corresponds to an indolent,destructive process of the lung due to invasion by aspergillus species,usually a. fumigatus. the diagnosis is confi rmed by a histological demonstration of tissue invasion by aspergillus species and its growth on culture. due to the difficulty in confirming the diagnosis,the following diagnosis criteria were established and when combined are highly indicative of npa: characteristic clinical and radiological fi ndings,elevation of infl ammatory markers and either serological results positive for aspergillus or the isolation of aspergillus from respiratory samples. active tuberculosis,non tuberculosis mycobacteriosis,cavitary histoplasmosis and coccidioidomycosis should be excluded. it is necessary to raise the level of suspicion and perform the adequate diagnostic tests in order to start therapy and avoiding disease progression. © 2010 published by elsevier españa,s.l. on behalf of sociedade portuguesa de pneumologia.