Aspergilloma

Aspergilloma is a medical condition characterized by the formation of a fungal ball (mycetoma) within a pre-existing cavity in the lung. This condition is primarily caused by the fungus Aspergillus species, most commonly Aspergillus fumigatus.

Etiology

Aspergilloma is not a primary infection but occurs when the Aspergillus fungus colonizes an existing cavity in the lung. These cavities may be the result of previous lung diseases such as tuberculosis, sarcoidosis, or lung abscess. The fungus forms a tangled mass, often described as a "fungus ball," within the cavity.

Clinical Presentation

Patients with aspergilloma may be asymptomatic or may present with symptoms such as chronic cough, hemoptysis (coughing up blood), and weight loss. Severe hemoptysis can be life-threatening and requires immediate medical attention.

Diagnosis

The diagnosis of aspergilloma is often made by imaging studies such as chest X-ray or computed tomography (CT) scan of the chest, which may show a characteristic "air crescent sign." This sign is a radiolucent crescent surrounding a radiodense mass within a cavity. Laboratory tests, including fungal cultures and serology, can also support the diagnosis.

Treatment

The treatment of aspergilloma depends on the patient's symptoms and overall health status. Asymptomatic patients may be managed with watchful waiting. For symptomatic patients, antifungal medications such as voriconazole and itraconazole may be used. In severe cases, surgical removal of the aspergilloma may be necessary.

Prognosis

The prognosis of aspergilloma varies widely and depends on the patient's overall health status, the presence of underlying lung disease, and the severity of symptoms.

Aspergilloma seen on a chest X-ray

See Also

• Pulmonary aspergillosis
• Chronic pulmonary aspergillosis
• Invasive aspergillosis

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