[Semi-invasive pulmonary aspergillosis. Apropos of a case].

A 43-year-old man was admitted to hospital for excavated pneumopathy of the upper part of the right lung, revealed by signs of respiratory infection evolving for a few weeks and involving a 10-kg weight loss. The radiological and clinical evolution and the demonstration of Aspergillus fumigatus allowed establishing a diagnosis of semi-invasive aspergillosis. The treatment, associating amphotericin B and 5-fluorocytosine, replaced by itraconazole 15 days later, soon produced clinical healing and radiological improvement. Since serology remained positive, surgery was performed to remove the residual lesions after a 7-month course of itraconazole. Within the scope of this case, the diagnostic criteria of this form of pulmonary aspergillosis are discussed, as well as the merits and limitations of itraconazole.