[Case of secondary chronic necrotic pulmonary aspergillosis that developed after pneumococcal pneumonia complicated by lung abscess formation].

The patient was a 61-year-old man. From the end of May 2007 he suffered from pain in the left anterior chest, had fever and consulted our hospital on May 27. On admission chest CT revealed consolidation in the left lung. In venous blood and sputum culture Streptococcus pneumoniae was identified as the causative organism, but despite improvement as a result of treatment, the upper lobe of the left lung showed cavity formation. Inside the cavity, fluid level formation was observed and percutaneous cavernous drainage was performed. Pus culture revealed infection with Aspergillus fumigatus, and we diagnosed chronic necrotizing pulmonary aspergillosis (CNPA). In addition to intravenous antifungal drug administration, 20 mg of amphotericin B (AMPH-B) was administered intracavitary. As symptoms and laboratory findings improved, the patient was discharged on October 12. We reported this case because pneumococcal pneumonia complicated by lung abscess formation is relatively rare, and topical treatment was effective against CNPA.