[A case of pulmonary infection induced by both Aspergillus sp. and Mycobacterium tuberculosis during corticosteroid therapy].

An 83-year-old woman with idiopathic thrombocytopenic purpura had received corticosteroid drugs since December 1998. Pulmonary aspergillosis appeared three months later, but improved with administration of itraconazole. When the dose of corticosteroid had to be increased again because of aggravation of the underlying disease after a 20-month gradually decreased use of the drugs, a new infiltration shadow in the left upper and middle fields appeared after one month of increase. Therefore, a detailed examination was performed. Mycobacterium tuberculosis was identified by the DDH method, Aspergillus sp. was isolated from the sputum culture, and aspergillus antigen was positive serologically, leading to a diagnosis of pulmonary infection induced by both Aspergillus sp. and Mycobacterium tuberculosis. Because of the prolonged administration of corticosteroid drugs, the patient was highly susceptible to infectious diseases. We considered this a case of interest because 20 months after the diagnosis of pulmonary aspergillosis, a mixed pulmonary infection of Mycobacterium tuberculosis and Aspergillus sp. was identified.