Invasive pulmonary aspergillosis in an immunocompetent diabetic patient: A case report and review of the literature

Introduction: Invasive pulmonary aspergillosis (IPA) is a serious opportunistic fungal infection that usually occurs in immunocompromised patients. However, it can exceptionally be seen in immunocompetent patients with chronic comorbidities such as diabetes.
Observation: We report the case of a 41-year-old patient with type 2 diabetes, with no other factors of immunosuppression, who presented with a productive cough, prolonged fever and minimal hemoptysis resistant to antibiotics. Chest CT scan showed micronodules in a ‘budding tree’ pattern. The diagnosis of IPA was confirmed by aspergillus PCR on bronchoalveolar lavage. The patient responded well to voriconazole.
Discussion: This case highlights the importance of considering invasive aspergillosis even in the absence of major immunosuppression. Diabetes, by impairing neutrophil function, is a significant risk factor. Chest imaging and fungal diagnostic tests (aspergillus antigen, PCR) play a central role in early diagnosis.
Conclusion: Invasive pulmonary aspergillosis should be considered in cases of antibiotic-resistant febrile pneumonia in diabetic patients. Early antifungal treatment improves the prognosis.