Chronic necrotising pulmonary aspergillosis: an uncommon aetiology of pneumothorax.

Pneumothorax is a frequent cause of admission in an emergency department. It can be due to a leakage of air from an air-filled lung cavitation into the pleural space. We report the unusual case of pneumothorax in a patient with a pulmonary cavitary infectious process mimicking tuberculosis. A 30-year-old asthmatic man, treated for several years with low-dose inhaled corticosteroids, presented a complete left tension pneumothorax and chronic necrotising pulmonary aspergillosis that mimicked initial pulmonary tuberculosis. Antifungal treatment by voriconazole was started and continued for 1 year, with a favourable outcome. This case highlights that chronic necrotising pulmonary aspergillosis is a diagnosis that should be considered in patients with a clinical presentation of pulmonary tuberculosis or in patients experiencing pneumothorax, especially in the context of corticosteroid treatment. 2014 BMJ Publishing Group Ltd.