To improve clinicians' understanding of primary invasive pulmonary aspergillosis (IPA) by collecting and analyzing the data of cases diagnosed at our hospital.

A retrospective study was performed to analyze all cases of IPA patients who were diagnosed at the First Affiliated Hospital of Guangxi Medical University from January 2012 to September 2018.

Among the 19 patients, 6 were male and 13 were female, with an average age of (42±14) years. The main symptoms included hemoptysis (84.2%, 16/19), cough (73.7%, 14/19), sputum production (63.2%, 12/19), dyspnea (10.5%, 2/19), chest pain (31.6%, 6/19), and fever (21.1%, 4/19). The wheezing sound was heard in only 1 (5.3%, 1/19) case. Laboratory examinations mainly revealed increased white blood cells (15.8%, 3/19), increased C-reactive protein (53.8%, 7/13), and positive galactomannan (GM) test (60.0%, 3/5). Of 14 cases who underwent pulmonary function assessments, 4 had ventilation dysfunction and dispersion dysfunction. Of 10 cases who underwent bronchoscopic examination, mucosal hyperemia was found in 8 cases, hemorrhage in 4, and abnormal airway secretions in 9. The main manifestations of chest imaging included cavities (47.4%, 9/19), nodules (52.6%, 10/19), consolidation (78.9%, 15/19), and air crescent (31.6%, 6/19). Eleven cases were misdiagnosed as tuberculosis, pneumonia, or inflammatory pseudotumor.

Primary IPA can occur in people without underlying disease, which is easily misdiagnosed. When a patient has cough, sputum, hemoptysis, and positive GM test, as well as CT manifestations of nodules, cavities, and air crescent, and when antibacterial treatment is ineffective, primary IPA should be considered.