Abstract
Pulmonary aspergilloma is a mycotic infection due to the development of a mass of hyphae in a preexisting cavity caused usually by tuberculosis. The aim of our study was to report the clinical, diagnostic, and therapeutic profile of pulmonary aspergilloma in our service. This is a retrospective study spread over 10 years (from January 2003 to September 2013) concerning 76 cases of pulmonary aspergilloma. The mean age was 49 years, with a male predominance (60.5%). The history of pulmonary tuberculosis was found in 97% of cases. The average time between the onset of tuberculosis and aspergillosis transplant was 10.5 years. Hemoptysis dominated the clinical picture (89.5%); it was minimal in 55% of cases, average abundance in 42% of cases and in great abundance in 1.6% of cases. Dyspnea was found in 70.5% of cases. Chest radiograph showed a bell image in 29% of cases, a destroyed lobe or destroyed lung in 28% of cases, cavitary lesions in 33% of cases and round opacities in 16% of cases. Chest CT, done for 64 patients, showed a truffle aspergillosis in 38% of cases. Bronchoscopy revealed an endobronchial bleeding in 24% of cases and aspergillus truffle in 5.2% of cases. Culture on Sabouraud agar of bronchial aspirate isolated aspergillus fumigatus in 10.5% of cases. The aspergillus serology was positive in 70% of cases. Sixty-six percent of patients were operated on. Medical treatment with itraconazole was recommended in 18.4% of cases. Pulmonary aspergillosis is the most common form of chest aspergillosis in our country because of the endemicity of tuberculosis. The radical treatment is surgery. We stress the importance of prevention and early and adequate management of pulmonary tuberculosis.
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