Tracheobronchial ulcers caused by Aspergillus infection is a potential cause of retrosternal pain: A case report and literature review

Retrosternal pain is a common symptom encountered in clinical practice. Although it is most frequently attributed to cardiac or esophageal disease, it is rarely considered an airway-related condition. Herein, we report the case of a patient who presented with fever, cough, retrosternal pain, dyspnea, and nausea accompanied by vomiting. The retrosternal pain was persistent and nonradiating and was aggravated by coughing. Based on the combination of retrosternal pain, fever, and dyspnea, viral myocarditis was strongly suspected. However, bronchoscopy performed after hospital admission revealed diffuse tracheobronchial ulcerations, and the patient was ultimately diagnosed with tracheobronchial ulcers and invasive pulmonary aspergillosis caused by Aspergillus infection. Following effective anti- Aspergillus treatment, the patient’s retrosternal pain gradually improved, suggesting that the pain was attributable to tracheobronchial ulceration. This case is rare and highlights the potential for diagnostic misinterpretation. We present this case to raise awareness of airway-related causes of retrosternal pain and to improve diagnostic accuracy.