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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 previously healthy tissue, causing an abscess.

    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 have been caused by:

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

    See also: Aspergillosis

    Symptoms

    You may not havesymptoms. 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 (see acute invasive aspergillosis)

    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. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 347.

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    • Lungs

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    • Pulmonary nodule - front...

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    • Pulmonary nodule, solita...

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    • Aspergilloma

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    • Pulmonary aspergillosis

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    • Aspergillosis - chest X-...

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    • Respiratory system

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      • Lungs

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      • Pulmonary nodule - front...

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      • Pulmonary nodule, solita...

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      • Aspergilloma

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      • Pulmonary aspergillosis

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      • Aspergillosis - chest X-...

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      • Respiratory system

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      A Closer Look

        Talking to your MD

          Self Care

            Tests for Pulmonary aspergilloma

            Review Date: 8/15/2012

            Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. 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. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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