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Chronic necrotizing pulmonary aspergillosis is un uncommon disease which is found in people with underlying lung disease or in mildly immunocompromised patients. It is an exceptional complication in silicosis and its diagnosis is difficult because it simulates other diseases like tuberculosis and cancer which are more common in such patients. We report on three cases with a long history of silica dust exposure with pulmonary aspergillosis complicating progressive massive fibrosis (PMF). We review their clinical, radiological and treatment features.

We discuss a case of a 68 years old man with an acute myocardial infarction and a cardiopulmonary arrest that 3 days after his admission developed a continuous abdominal pain and findings of peritoneal inflammation. The mesenteric angiographical study was normal. A laparotomy was practised and disclosed a local peritonitis and a colonic infarction without mesenteric vascular occlusion. This picture is very unusual in patients with acute myocardial infarction or cardiopulmonary arrest.