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Pulmonary aspergilloma

Fungus ball; Mycetoma; Aspergilloma; Aspergillosis - pulmonary aspergilloma

 

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

Causes

 

Aspergillosis is an infection caused by the fungus aspergillus. Aspergillomas are formed when the fungus grows in a clump in a lung cavity. The cavity is often created by a previous condition. Cavities in the lung may be caused by diseases such as:

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

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.

 

Symptoms

 

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

  • Chest pain
  • Cough
  • Coughing up blood, which can be a life-threatening sign
  • Fatigue
  • Fever
  • Unintentional weight loss

 

Exams and Tests

 

Your health care provider may suspect you have a fungal infection after x-rays of your lungs show the ball of fungus. Other tests that may be done include:

  • Biopsy of lung tissue
  • Blood test for presence of aspergillus in the body (galactomannan)
  • Blood test to detect immune response to aspergillus (specific antibodies for aspergillus)
  • Bronchoscopy or bronchoscopy with lavage
  • Chest CT
  • Sputum culture

 

Treatment

 

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

Sometimes, antifungal medicines may be used.

If you have bleeding in the lungs, your provider may inject dye into the blood vessels (angiography) to find the site of bleeding. The bleeding is stopped by either:

  • Surgery to remove the aspergilloma
  • Procedure that inserts material into the blood vessels (embolization)

 

Outlook (Prognosis)

 

The outcome can be good in many people. 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

 

Complications of pulmonary aspergilloma may include:

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

 

When to Contact a Medical Professional

 

See your 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

Horan-Saullo JL, Alexander BD. Opportunistic mycoses. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 38.

Walsh TJ. Aspergillosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 339.

 
  • Lungs

    Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Pulmonary nodule - front view chest X-ray

    Pulmonary nodule - front view chest X-ray - illustration

    This x-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.

    Pulmonary nodule - front view chest X-ray

    illustration

  • Pulmonary nodule, solitary - CT scan

    Pulmonary nodule, solitary - CT scan - illustration

    This CT scan shows a single lesion (pulmonary nodule) in the right lung. This nodule is seen as the light circle in the upper portion of the dark area on the left side of the picture. A normal lung would look completely black in a CT scan.

    Pulmonary nodule, solitary - CT scan

    illustration

  • Aspergilloma

    Aspergilloma - illustration

    Aspergillosis is an acute pulmonary infection caused by the aspergillus fungus. Aspergillus can cause illness three ways: an allergic reaction in asthmatics; a colonization in scarred lung tissue; and an invasive infection with pneumonia which can affect the heart, lungs, brain and kidneys.

    Aspergilloma

    illustration

  • Pulmonary aspergillosis

    Pulmonary aspergillosis - illustration

    Aspergillosis is an acute pulmonary infection caused by the aspergillus fungus. Aspergillus can cause illness three ways: an allergic reaction in asthmatics; a colonization in scarred lung tissue; and an invasive infection with pneumonia which can affect the heart, lungs, brain and kidneys.

    Pulmonary aspergillosis

    illustration

  • Aspergillosis - chest X-ray

    Aspergillosis - chest X-ray - illustration

    Aspergillosis is a fungal infection. The fungus invades and destroys tissue. This type of infection usually occurs in immunocompromised individuals. Here, a chest x-ray shows that the fungus has invaded the lung tissue. The lungs are usually seen as black areas on an x-ray. The cloudiness on the left side of this x-ray is caused by the fungus.

    Aspergillosis - chest X-ray

    illustration

  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Lungs

      Lungs - illustration

      The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

      Lungs

      illustration

    • Pulmonary nodule - front view chest X-ray

      Pulmonary nodule - front view chest X-ray - illustration

      This x-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.

      Pulmonary nodule - front view chest X-ray

      illustration

    • Pulmonary nodule, solitary - CT scan

      Pulmonary nodule, solitary - CT scan - illustration

      This CT scan shows a single lesion (pulmonary nodule) in the right lung. This nodule is seen as the light circle in the upper portion of the dark area on the left side of the picture. A normal lung would look completely black in a CT scan.

      Pulmonary nodule, solitary - CT scan

      illustration

    • Aspergilloma

      Aspergilloma - illustration

      Aspergillosis is an acute pulmonary infection caused by the aspergillus fungus. Aspergillus can cause illness three ways: an allergic reaction in asthmatics; a colonization in scarred lung tissue; and an invasive infection with pneumonia which can affect the heart, lungs, brain and kidneys.

      Aspergilloma

      illustration

    • Pulmonary aspergillosis

      Pulmonary aspergillosis - illustration

      Aspergillosis is an acute pulmonary infection caused by the aspergillus fungus. Aspergillus can cause illness three ways: an allergic reaction in asthmatics; a colonization in scarred lung tissue; and an invasive infection with pneumonia which can affect the heart, lungs, brain and kidneys.

      Pulmonary aspergillosis

      illustration

    • Aspergillosis - chest X-ray

      Aspergillosis - chest X-ray - illustration

      Aspergillosis is a fungal infection. The fungus invades and destroys tissue. This type of infection usually occurs in immunocompromised individuals. Here, a chest x-ray shows that the fungus has invaded the lung tissue. The lungs are usually seen as black areas on an x-ray. The cloudiness on the left side of this x-ray is caused by the fungus.

      Aspergillosis - chest X-ray

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

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          Review Date: 7/31/2016

          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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