A 51-year-old man presented with refractory hemoptysis due to multiple invasive pulmonary aspergilloma. After the failure of endovascular embolization, we performed a right pneumonectomy to control hemoptysis. Nine months after the operation, he presented to the emergency room with dyspnea and fever. Chest computed tomography showed air in the pericardium. A pleural fluid smear showed fungal hypha. Pneumopericardium caused by Aspergillus empyema was diagnosed. Irrigation and debridement of the empyema were performed, and the patient's dyspnea resolved. A follow-up chest computed tomography scan showed complete resolution of the empyema and pneumopericardium. Pneumopericardium is an unusual complication of Aspergillus empyema.
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