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Background <p>While pulmonary aspergillosis constitutes a common fungal infection with typical respiratory manifestations, its association with tracheal cartilage exfoliation is an exceedingly rare complication. This report describes a case in a 55-year-old female, detailing the clinical presentation, therapeutic management, and follow-up to elucidate this unusual disease process.</p> Case presentation <p>A middle-aged diabetic woman presented with cough, wheezing, and sputum. Imaging and bronchoscopy identified a tracheal mass, with biopsy confirming fungal (likely Aspergillus) infection.During intravenous voriconazole treatment, she coughed out a piece of cartilage, confirming tracheal invasion. Follow-up showed tracheal stenosis, granulation tissue, and cartilage destruction.Over the time her symptoms resolved. Follow-up CT showed stable tracheal narrowing, with good recovery.</p> Conclusion <p>Despite improved diagnostics for pulmonary fungal infections, tracheal cartilage exfoliation due to Aspergillus remains a serious concern. The fungus secretes endotoxins and proteases that cause tissue necrosis and cartilage invasion, leading to exfoliation prone to misdiagnosis and life-threatening asphyxia. Therefore, thorough patient education about this risk is essential.</p> Clinical trial number <p>Not applicable.</p>

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Aspergillus pseudomembranous tracheitis leading to tracheal cartilage exfoliation: uncommon disease with rare presentation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月23日

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  • Jiayue Wang,
  • Jie Huang,
  • Jidong Liu,
  • Xiaowei Cheng

摘要

Background

While pulmonary aspergillosis constitutes a common fungal infection with typical respiratory manifestations, its association with tracheal cartilage exfoliation is an exceedingly rare complication. This report describes a case in a 55-year-old female, detailing the clinical presentation, therapeutic management, and follow-up to elucidate this unusual disease process.

Case presentation

A middle-aged diabetic woman presented with cough, wheezing, and sputum. Imaging and bronchoscopy identified a tracheal mass, with biopsy confirming fungal (likely Aspergillus) infection.During intravenous voriconazole treatment, she coughed out a piece of cartilage, confirming tracheal invasion. Follow-up showed tracheal stenosis, granulation tissue, and cartilage destruction.Over the time her symptoms resolved. Follow-up CT showed stable tracheal narrowing, with good recovery.

Conclusion

Despite improved diagnostics for pulmonary fungal infections, tracheal cartilage exfoliation due to Aspergillus remains a serious concern. The fungus secretes endotoxins and proteases that cause tissue necrosis and cartilage invasion, leading to exfoliation prone to misdiagnosis and life-threatening asphyxia. Therefore, thorough patient education about this risk is essential.

Clinical trial number

Not applicable.