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Aspergillosis of the Lung Presenting as Hemoptysis
R.L Gupta ,Nsaxena,Sharad Kumar,Monika Mahajan.
JK Science : Journal of Medical Education & Research , 2000,
Abstract: Among mycotic diseases of the lung, pulmonary aspergillosis caused by aspergilloma fumigatlls isthe one encountered most frequently. An unusual case with a cystic lesion in thc lung which turnedout to be an aspergilloma is presented here.
Bronquiolite obliterante com pneumonia em organiza??o e aspergiloma em paciente com linfoma-leucemia de células T
Jornal de Pneumologia , 2000, DOI: 10.1590/S0102-35862000000100011
Abstract: there are few reports in the medical literature about association between bronchiolitis obliterans with organizing pneumonia (boop) and aspergilloma. this report shows the presence of both boop and pulmonary aspergilloma in a patient with adult t cell leukemia-lymphoma. it is suggested that these findings represent a random association rather than the expression of a nosologic unity.
Pathology of pulmonary aspergillomas  [cached]
Shah Rajeev,Vaideeswar Pradeep,Pandit Shobhana
Indian Journal of Pathology and Microbiology , 2008,
Abstract: Aspergilloma refers to a fungal ball formed by saprophytic overgrowth of Aspergillus species and is seen secondary to cavitatory/cystic respiratory diseases. Paucity of clinical and pathological data of aspergilloma in India prompted us to analyze cases of aspergilloma over 15 years. The clinical features were recorded in all and correlated with detailed pathological examination. Aspergillomas were identified in 41 surgical excisions or at autopsy. There was male predominance; half the patients were in their fourth decade. Episodic hemoptysis was the commonest mode of presentation (85.4%). Forty aspergillomas were complex, occurring in cavitatory lesions (82.9%) or in bronchiectasis (14.6%). Simple aspergilloma was seen as an incidental finding in only one. Tuberculosis was the etiological factor in 31 patients, producing cavitatory or bronchiectatic lesions; other causes were chronic lung abscess and bronchiectasis (unrelated to tuberculosis). Surgical resections are endorsed in view of high risk of unpredictable, life-threatening hemoptysis.
Tratamento cirúrgico de aspergiloma pulmonar
Ruiz Júnior, Raul Lopes;Oliveira, Frederico Henrique Sobral de;Piotto, Bruno Luiz Burgos;Muniz, Felipe Antunes e Silva de Souza Lopes;Cataneo, Daniele Cristina;Cataneo, Antonio José Maria;
Jornal Brasileiro de Pneumologia , 2010, DOI: 10.1590/S1806-37132010000600016
Abstract: the objective of this study was to analyze the outcome of surgical treatment of pulmonary aspergilloma. to that end, we evaluated 14 adult patients so treated between 1981 and 2009 at the botucatu school of medicine university hospital, in the city of botucatu, brazil. data were collected from the medical records of the patients. ten patients (71%) presented with simple pulmonary aspergilloma, and 4 (29%) presented with complex pulmonary aspergilloma. hemoptysis was the most common symptom, and tuberculosis was the most prevalent preexisting lung disease. two patients (14%) underwent surgery on more than one occasion. there were no intraoperative deaths. half of the patients developed postoperative complications, prolonged air leak and empyema being the most common.
Chronic Necrotising Aspergillosis: a less known entity  [cached]
Mitra Subhra,Mitra Apratim,Dey Atin
Journal of Association of Chest Physicians , 2013,
Abstract: Chronic necrotising aspergillosis (CNA), as opposed to aspergilloma, is a rare condition associated with a semi-invasive, subacute destructive process of the lung parenchyma, the mainstay of its treatment being anti-fungal therapy. We describe a patient who was initially diagnosed as a case of aspergilloma of right lung and who underwent a partial resection of the cavity only to present four months later with an increasing cavity size and soft tissue mass suggestive of chronic necrotising aspergillosis. He died due to sepsis and respiratory failure complicating CNA five days after admission.
Bola fúngica por Aspergillus fumigatus em cavidade pleural
Guazzelli, Luciana Silva;Severo, Cecília Bittencourt;Hoff, Leonardo Santos;Pinto, Geison Leonardo Fernandes;Camargo, José Jesus;Severo, Luiz Carlos;
Jornal Brasileiro de Pneumologia , 2012, DOI: 10.1590/S1806-37132012000100017
Abstract: objective: to report the cases of 6 patients with fungus ball caused by aspergillus fumigatus (aspergilloma) in the pleural cavity. methods: between 1980 and 2009, 391 patients were diagnosed with aspergilloma at the santa casa hospital complex in porto alegre, brazil. the diagnosis of aspergilloma in the pleural cavity was made through imaging tests revealing effusion and pleural thickening with air-fluid level; direct mycological examination revealing septate hyphae, consistent with aspergillus sp.; and positive culture for a. fumigatus in the surgical specimen from the pleural cavity. results: of the 391 patients studied, 6 (2%) met the established diagnostic criteria. the mean age of those 6 patients was 48 years (range, 29-66 years), and 5 (83%) were male. the most common complaints were cough, expectoration, and hemoptysis. four patients (67%) had a history of tuberculosis that had been clinically cured. all of the patients were submitted to surgical removal of the aspergilloma, followed by intrapleural instillation of amphotericin b, in 4; and 2 received systemic antifungal treatment p.o. there was clinical improvement in 5 patients, and 1 died after the surgery. conclusions: in adult patients with a history of cavitary lung disease or pleural fistula, a careful investigation should be carried out and fungal infection, especially aspergilloma, should be taken into consideration. in such cases, laboratory testing represents the most efficient use of the resources available to elucidate the diagnosis.
Aspergillosis of the central nervous system
Golin, Valdir;Sprovieri, Sandra Regina Schwarzwalder;Can?ado, José Eduardo Delfini;Daniel, Jefferson Walter;Mimica, Lycia Maria Jenné;
Sao Paulo Medical Journal , 1996, DOI: 10.1590/S1516-31801996000500007
Abstract: the authors report an unusual case involving a 38 year-old man who developed a intracranial abscess caused by aspergillus of the parietal lobe. cerebral aspergilloma of an initial pulmonary origin developed in a patient with "fungus ball" secondary to tuberculosis sequelae. the diagnosis was made through the isolation of aspergillus from the secretion of the brain abscesses. the patient was treated with drainage of the abscesses and amphotericin b. he presented a progressive regression of the radiological images (brain and pulmonary) over a period of 55 days. this report emphasizes the importance of combined anti-fungal therapy and surgical resection as a treatment for cerebral aspergilloma. furthermore, an early initiation of therapy should improve the prognosis in such cases.
Ekinokok Kisti Kavitesinde Aspergillus Kolonizasyonu: Olgu Sunumu  [cached]
Duygu GüREL,Aydanur KARGI,Mehtat üNLü,Ayd?n ?ANLI
Türk Patoloji Dergisi , 2011,
Abstract: Although lungs are common sites for the occurrence of saprophytic or invasive mycosis as well as hydatid cyst, aspergilloma within a hydatid cyst is a rare occurrence.A 36-year-old immunocompetent male presented with hemoptysis episodes of about 1 year duration. Chest X-ray revealed a smooth countered mass lesion located in the upper part of lower lobe of left lung. Surgical enucleation of the cyst wall was performed. Microscopic examination showed that the laminated membranes of hydatid cyst were invaded by septated fungal hyphea oriented with acute angles consistent with aspergillus.Herein, we report such a unique coexistence of hydatid cyst and aspergilloma, and emphasize possible complications depending on the immunostatus of the patient, if the aspergillus colonization is unnoticed in resected cystectomy material.
Capítulo 5 - Aspergilose: do diagnóstico ao tratamento
Sales, Maria da Penha Uchoa;
Jornal Brasileiro de Pneumologia , 2009, DOI: 10.1590/S1806-37132009001200012
Abstract: aspergillosis is a multifaceted disease whose clinical manifestations (allergic, saprophytic and invasive forms) are determined by the host immune response. allergic bronchopulmonary aspergillosis is characterized by corticosteroid-dependent asthma, fever, hemoptysis and destruction of the airways, which can evolve to fibrosis with honeycombing. the treatment consists of the combined use of a corticosteroid and itraconazole. invasive pulmonary aspergillosis, which has a worse prognosis, is diagnosed based on histopathological documentation and positive culture of a sterile specimen. the treatment response obtained with voriconazole is better, in terms of survival and safety, than that obtained with amphotericin b. in patients with chronic pulmonary disease who are mildly immunocompromised, chronic necrotizing pulmonary aspergillosis causes progressive destruction of the lung. such patients are treated with oral itraconazole. chronic cavitary pulmonary aspergillosis causes multiple cavities, with or without aspergilloma, accompanied by pulmonary and systemic symptoms. in patients with chronic pulmonary disease, the aspergilloma is characterized by chronic productive cough and hemoptysis, together with a cavity containing a rounded, sometimes mobile, mass separated from the cavity wall by airspace. surgical resection is the definitive treatment for both types of aspergillosis. triazole fungicides provide long-term treatment benefits with minimal risk.
Role of itraconazole in the management of aspergillosis in treated patients of pulmonary tuberculosis  [cached]
Gupta P,Vyas Aruna,Meena R,Khangarot S
Lung India , 2005,
Abstract: Sputum/ bronchial washings of 445 patients with residual tubercular cavitation were subjected to smear and culture examination to isolate fungi. Patients suffering from aspergillosis were put on oral itraconazole daily for 6 months and monitored clinicoradiologically during and after therapy. About half of the patients of aspergilloma and 85% of the patients of chronic necrotizing pulmonary aspergillosis improved by 3 months of therapy. Nausea and headache observed during therapy in 8 and 4 patients respectively were mild and self limiting. Relapses were seen in 8 out of the 37 patients who had completed 6 months therapy and available for follow-up.
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