Abstract
Chronic pulmonary aspergillosis (CPA) is primarily seen in individuals with pre-existing lung pathology like bronchiectasis, cystic fibrosis, chronic obstructive pulmonary disease, or subtle immune compromise. It is rare in pregnancy and poses significant diagnostic and therapeutic challenges. We report a rare case of CPA in a young pregnant woman who was initially diagnosed with bronchiectasis secondary to meningococcal septicaemia in early childhood. She had recurrent haemoptysis during both pregnancies. During her current pregnancy, she presented with worsening respiratory symptoms and was ultimately managed with bronchial artery embolisation. Surgical intervention was deferred until postpartum. A planned caesarean delivery was undertaken at 34 weeks and 2 days due to the risk of massive haemoptysis. Postpartum, she was initiated on antifungal therapy and subsequently underwent definitive treatment with right lower pulmonary lobectomy. This case underscores the importance of appropriate diagnosis and timely management of complex respiratory conditions during pregnancy, particularly the role of a multidisciplinary team.