A Rare Case of Lymphoma with Invasive Pulmonary Aspergillosis Developing Azole Resistance

This study reports a rare case of azole-resistant invasive pulmonary aspergillosis (IPA) in a patient with diffuse large B-cell lymphoma and to underscore the clinical relevance of emerging azole resistance in hematologic malignancies. Clinical, microbiological, and radiological findings were reviewed in a patient who developed IPA. Antifungal susceptibility testing was performed, and the clinical response was evaluated after modification of antifungal therapy. Despite antifungal treatment with voriconazole, azole resistance was detected. Switching back to amphotericin B resulted in marked clinical and radiological improvement, supporting the diagnosis of azole-resistant IPA. Azole resistance, though uncommon, is an increasingly important therapeutic concern in immunocompromised hosts. Early recognition and timely initiation of alternative agents such as amphotericin B may improve outcomes.