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HRCT scan (March 2017).
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A 27-year-old male newly diagnosed with AD-HIES with mutation in STAT3 (c.1406A > G; c.1406A) was referred to a pulmonology clinic by the infectious disease clinic, because of incidental finding of large pulmonary infiltrates on his chest X-ray and computed tomography (CT) thorax as well as a cavity with a fungal ball-looking lesion (Figure 1).
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Graph showing voriconale treatment and correlation with C-reactive protein over
time.
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BAL findings of S. pneumoniae and Achromobacter sp. Because of the high suspicion of pulmonary Aspergillosis, empiric Voriconazole treatment was prescribed for 11 months (Figure 2).
CT/PET image showing high FDG uptake in the right-sided infiltrate (May 2017).
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A control CT/positron emission tomography (PET) (Figure 3) 2 months later showed increased fluorodeoxyglucose (FDG) uptake at the level of the cavity; 8 months later a high-resolution computed tomography (HRCT) scan (Figure 4) showed further progression of cavitating lesion in the right upper lobe and new infiltrates caudally.
CT scan showing progressing infiltrate (Dec 2017).
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A control CT/positron emission tomography (PET) (Figure 3) 2 months later showed increased fluorodeoxyglucose (FDG) uptake at the level of the cavity; 8 months later a high-resolution computed tomography (HRCT) scan (Figure 4) showed further progression of cavitating lesion in the right upper lobe and new infiltrates caudally.
HRCT scan with partial resolution after treatment with oral glucocorticoids (May
2018).
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A control CT thorax (Figure 5) after 1 month of this treatment regimen showed some regression of the infiltrate.
HRCT with further resolution of infiltrative changes (May 2019).
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A further follow-up CT thorax (Figure 6) 12 months later showed further regression of the infiltrate.
Graph showing Prednisolone treatment and correlation with leukocytes, neutrophils and
lymphocytes over time.
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The Prednisolone treatment was subsequently stopped (Figure 7).