The fungus attacks the lungs, causing effusion

Mr. Tinh has smoked for more than 50 years but has quit for about 8 months and does not have chronic obstructive pulmonary disease (COPD) or tuberculosis. Dr. Tran Minh Giang, General Internal Medicine Unit, Tam Anh General Clinic, District 7, said the patient had effusion on both sides of the pleura, causing this organ to not expand normally when breathing.

Mr. Tinh was transferred to Tam Anh General Hospital in Ho Chi Minh City to have pleural fluid drained to help the organ have more space to expand, reducing difficulty breathing. Blood tests showed increased inflammation index, reflecting the body’s inflammatory response and infection.

After two weeks, Mr. Tinh had no difficulty breathing, the amount of pleural fluid decreased, but the response to treatment was not clear. Dr. Giang increased the dose of antibiotics and added antifungal medication because he suspected the patient’s fungal infection was due to environmental factors (because the patient lived in an agricultural growing area with many warehouses). After that, the patient responded well to treatment, pleural fluid decreased clearly, and symptoms of cough and shortness of breath decreased.

Test results determined that the causative agent was Aspergillus fungus. This type of mold is common in the natural environment, often existing in the air, dust, soil, rotten straw, and long-term stored grains. Depending on the type of infection, Aspergillus fungi can cause respiratory failure due to severe bleeding in the lungs or systemic infection. The most serious complication is infection that spreads to other parts of the body such as the brain, heart, and kidneys.

After 6 weeks of combined antibiotic and antifungal treatment, the patient’s lungs were well ventilated and there was no more pleural effusion.

According to Dr. Giang, lung fungal infections are often difficult to detect in the early stages because the disease progresses silently, and clinical manifestations are easily confused with pneumonia. People with underlying diseases like COPD, bronchiectasis, history of tuberculosis… need to proactively prevent by wearing masks when working in dusty, moldy environments. Patients should not arbitrarily use antibiotics or corticosteroids without a doctor’s prescription. When coughing, shortness of breath persists, fever of unknown cause or conventional pneumonia treatment does not respond, the patient needs to go to a reputable medical facility for examination.