Photographic Negative Pulmonary Oedema Secondary to Aspergillus Flavus

Background: This article reports a unique case of severe pulmonary aspergillosis triggered by Aspergillus flavus infection, culminating in organising pneumonia with alveolar leaks and severe respiratory distress in a previously healthy individual. The patient, a 48-year-old man, presented with symptoms of fever, dry cough, and hypoxia, with imaging revealing bilateral ground-glass consolidations reminiscent of photographic negative pulmonary oedema. Bronchoalveolar lavage confirmed the presence of Aspergillus flavus hyphae, establishing the diagnosis of aspergillosis-induced organising pneumonia. Initial treatment with Initial treatment with voriconazole and methylprednisolone yielded partial improvement. However, the patient experienced subsequent deterioration, necessitating amphotericin therapy. This case underscores the potential association between Aspergillus flavus infection and the pathogenesis of organising pneumonia, particularly in immunocompetent individuals. The presentation of severe respiratory compromise in the absence of predisposing factors highlights the diagnostic and therapeutic challenges posed by such cases. This case serves as a compelling reminder of the diverse clinical manifestations of Aspergillus infections and underscores the importance of considering fungal aetiologies in the differential diagnosis of organising pneumonia, particularly in the absence of overt immunodeficiency.