Chest
Clinical InvestigationsSpontaneous Lysis of Aspergillomata
Section snippets
Methods
The cases on which this report is based were selected from a consecutive series of patients with aspergiliomata who were hospitalized at one of the institutions participating in the CDC Cooperative Mycoses Study. The study, described in detail elsewhere,12 consists of a central office which verifies diagnoses and maintains follow-up of all cases of deep mycoses confirmed at participating hospitals. The diagnosis of aspergilloma was based on the characteristic radiographic appearance of an
Case 1
A 61-year-old man with a history of treated pulmonary tuberculosis was hospitalized in September, 1970, when it was noted that a mass was present in a large right upper lobe (RUL) cavity (Fig 1). Tomograms confirmed the presence of an intracavitary mass and Aspergillus fumigatus was grown from four sputum specimens. Since the patient reported no change in his condition and did not complain of hemoptysis, no treatment was advised, and on his return visit in January, 1971, a chest roentgenogram (
Discussion
The four cases presented all represent the occurrence of an aspergilloma in a pulmonary cavity followed by spontaneous clearing of the fungous ball after 4, 12, 12, and 69 months of observation. Two patients never received antifungal agents and two received amphotericin B intravenously. It is unlikely that amphotericin B played a role in causing lysis in the two treated patients. Lysis of the aspergillomata occurred at least six and four months, respectively, after completion of treatment, and
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Cited by (53)
Direct transbronchial administration of liposomal amphotericin B into a pulmonary aspergilloma
2014, Respiratory Medicine Case ReportsCitation Excerpt :However, all treatments should aim to cure the condition for the reasons outlined below. Balls of fungal mycelia are not static and can invade the surrounding lung tissue, leading to chronic necrotizing pulmonary aspergillosis [3], although spontaneous aspergilloma lysis occurs in 7–10% of cases [17]. Furthermore, hemoptysis of bronchial arterial origin can arise and is sometimes lethal in partially treated cases, with the mortality rate ranging from 2 to 26% [18].
Pulmonary aspergilloma. Clinical aspects and surgical treatment outcome
2012, Thoracic Surgery ClinicsCitation Excerpt :Moreover, lung cancer is common and possibly related to tubercular sequelae (scar cancer).59 In a few patients, aspergillomas seem to stabilize and remain asymptomatic for many years; a UK resurvey60 reported an occasional apparent regression of aspergillomas, sometimes following a superadded bacterial infection; a spontaneous resolution has also been reported but it seems to be an anecdotal event.61 The only effective treatment of a pulmonary mycetoma is surgery.
Bronchopulmonary aspergillosis infections in the non-immunocompromised patient
2007, Revue de Pneumologie CliniquePulmonary aspergillosis
2001, Netherlands Journal of MedicinePercutaneous management of intrapulmonary air and fluid collections
2000, Radiologic Clinics of North AmericaCitation Excerpt :Therapeutic management of pulmonary aspergillomas is controversial. In patients who are asymptomatic, clinical and radiographic observation may be the best management strategy because spontaneous lysis of pulmonary aspergillomas occurs in 7% to 10% of patients,11 medical treatment with systemic antifungal agents is ineffective in most patients and has a substantial risk of renal and hepatic toxicity,8,12,17,27 and surgical resection is associated with high morbidity and mortality.22,42 Transcatheter arterial embolization therapy is usually the initial treatment of choice for patients presenting with acute life-threatening hemoptysis.6,7,20,22,42,46
The therapeutic dilemma in pre-transplant asymptomatic aspergilloma: A case report and review of literature
2021, Saudi Journal of Kidney Diseases and Transplantation
Manuscript received May 14; revision accepted July 26.