Invasive Pulmonary Aspergillosis (IPA) is a fatal opportunistic infection in immunocompromised patients which can be rarely associated with pleural or pericardial involvement. We describe a case of 30 year old male diagnosed with T-ALL who developed IPA complicated with pneumopericardium and pneumothorax during remission induction phase of chemotherapy, initially treated with voriconazole for 3 weeks, which caused severe hepatotoxicity and subsequently, successfully treated with IV amphorericin B for 8 weeks, in a resource limited setting. Cardiac tamponade was prevented by timely aspiration of the pericardial effusion.
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