Pulmonary Aspergillus Nodule in an Immunocompetent Host: A Case Report

Aspergillus is a common fungal pathogen that typically causes severe infections in patients with compromised immunity. This report explores a rare case of a pulmonary Aspergillus nodule in an immunocompetent person without underlying conditions. A 52-year-old man initially presented for evaluation of his son's allergic rhinitis, during which a chronic cough accompanied by brown sputum was incidentally discovered. The cough started 4 months previously and then gradually worsened. He had a smoking history of 24 pack-years, without any other symptoms or underlying diseases. A chest X-ray and spiral lung CT scan revealed round haziness in the left lower lobe compatible with a pulmonary mass, leading to the diagnosis of a pulmonary Aspergillus nodule, which was confirmed by needle aspiration staining and culture. Treatment with voriconazole resulted in significant improvement and reduction in the size of the mass during the 3-month follow-up period. This case highlights the potential for pulmonary Aspergillus nodules to develop in immunocompetent individuals.