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Pulmonary aspergilloma

Fungus ball; Mycetoma; Aspergilloma

 

Pulmonary aspergilloma is a mass caused by a fungal infection that usually grows in lung cavities. It can also appear in the brain, kidney, or other organs.

Causes

 

Aspergillomas are formed when the fungus Aspergillus grows in a clump in a lung cavity, or invades healthy tissue, causing an abscess. The most common species of fungus that causes disease in humans is Aspergillus fumigatus.

Aspergillus is a common fungus. It grows on dead leaves, stored grain, bird droppings, compost piles, and other decaying vegetation. Cavities in the lung may be caused by:

  • Tuberculosis
  • Coccidioidomycosis
  • Cystic fibrosis
  • Histoplasmosis
  • Lung abscess
  • Lung cancer
  • Sarcoidosis

See also: Aspergillosis

 

Symptoms

 

You may not have symptoms. When symptoms do develop, they can include:

  • Chest pain
  • Cough
  • Coughing up blood
  • Fatigue
  • Fever
  • Unintentional weight loss

 

Exams and Tests

 

  • Biopsy of lung tissue
  • Blood test for presence of aspergillus in the body (galactomannan)
  • Blood test to detect antibodies to aspergillus (serum precipitins for aspergillus)
  • Bronchoscopy or bronchoscopy with lavage
  • Chest CT
  • Chest x-ray
  • Sputum culture

 

Treatment

 

Many patients never develop symptoms. Often, no treatment is needed, unless you are coughing up blood.

Occasionally, antifungal medications may be used.

If you have bleeding in the lungs, your doctor may inject dye into the blood vessels (angiography) to find the site of bleeding. The bleeding is stopped by shooting tiny pellets into the bleeding vessel.

Surgery is often the only choice if there is life-threatening bleeding.

 

Outlook (Prognosis)

 

The outcome can be good in many patients. However, it depends on the severity of the condition and your overall health.

Surgery may be very successful in some cases, but it is complex and can have a high risk of serious complications.

 

Possible Complications

 

  • Difficulty breathing that gets worse
  • Massive bleeding from the lung
  • Spread of the infection

 

When to Contact a Medical Professional

 

See your health care provider if you cough up blood, and mention any other symptoms that have developed.

 

Prevention

 

People who have had related lung infections or who have weakened immune systems should try to avoid environments where the aspergillus fungus is found.

 

 

References

Patterson TF. Aspergillus species. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 258.

Walsh TJ, Stevens DA. Aspergillosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 347.

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  • Pulmonary nodule - front view chest X-ray

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  • Pulmonary nodule, solitary - CT scan

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  • Aspergilloma

    Aspergilloma

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  • Pulmonary aspergillosis

    Pulmonary aspergillosis

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  • Aspergillosis - chest X-ray

    Aspergillosis - chest X-...

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  • Respiratory system

    Respiratory system

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    • Lungs

      Lungs

      illustration

    • Pulmonary nodule - front view chest X-ray

      Pulmonary nodule - front...

      illustration

    • Pulmonary nodule, solitary - CT scan

      Pulmonary nodule, solita...

      illustration

    • Aspergilloma

      Aspergilloma

      illustration

    • Pulmonary aspergillosis

      Pulmonary aspergillosis

      illustration

    • Aspergillosis - chest X-ray

      Aspergillosis - chest X-...

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    • Respiratory system

      Respiratory system

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            Review Date: 8/31/2014

            Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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