Chest
Volume 64, Issue 6, December 1973, Pages 697-699
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Clinical Investigations
Spontaneous Lysis of Aspergillomata

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Spontaneous lysis of an aspergilloma occurred in four patients out of a consecutive series of 41 aspergillomata in 37 patients. The occurrence of spontaneous lysis in approximately 10 percent of aspergillomata is significant and should be considered when evaluating claims of effective medical treatment.

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

References (12)

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Manuscript received May 14; revision accepted July 26.

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