# Pregnancy Complicated by Chronic Pulmonary Aspergillosis

## TL;DR

A rare case of chronic pulmonary aspergillosis in a pregnant woman highlights the challenges in diagnosis and treatment during pregnancy.

## Contribution

This paper presents a rare clinical case of chronic pulmonary aspergillosis during pregnancy and emphasizes the importance of multidisciplinary management.

## Key findings

- Chronic pulmonary aspergillosis can occur in pregnancy and may present with worsening respiratory symptoms.
- Multidisciplinary management, including bronchial artery embolisation and planned caesarean delivery, is crucial for managing such cases.
- Definitive treatment with pulmonary lobectomy was performed postpartum after initiating antifungal therapy.

## Abstract

Chronic pulmonary aspergillosis (CPA) is primarily seen in individuals with pre-existing lung pathology like bronchiectasis, cystic fibrosis, chronic obstructive pulmonary disease, or subtle immune compromise. It is rare in pregnancy and poses significant diagnostic and therapeutic challenges. We report a rare case of CPA in a young pregnant woman who was initially diagnosed with bronchiectasis secondary to meningococcal septicaemia in early childhood. She had recurrent haemoptysis during both pregnancies. During her current pregnancy, she presented with worsening respiratory symptoms and was ultimately managed with bronchial artery embolisation. Surgical intervention was deferred until postpartum. A planned caesarean delivery was undertaken at 34 weeks and 2 days due to the risk of massive haemoptysis. Postpartum, she was initiated on antifungal therapy and subsequently underwent definitive treatment with right lower pulmonary lobectomy. This case underscores the importance of appropriate diagnosis and timely management of complex respiratory conditions during pregnancy, particularly the role of a multidisciplinary team.