Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease and Disseminated Aspergillosis

Inhaled corticosteroids are widely used in patients with chronic obstructive pulmonary disease (COPD), although their efficacy is still being debated. Due to local and systemic effects, such therapy can have an immunosuppressive action and opportunistic infections can occur. In the present case, a 74-year-old man treated with inhaled corticosteroids for 5 years developed disseminated aspergillosis. No other immunosuppressive factor was found. To our knowledge, only a few cases of lung aspergillosis in such patients have been described in the literature. However, the risk-to-benefit ratio of this treatment must be reassessed.