DR Medhat MRCP

Aspergilloma :
- A fungus ball that usually colonises a pre-excisting lung cavity e.g TB , cancer, CF .
• Features :
Usually asymptomatic : but may be :
Cough.
سؤال severe). Haemoptysis (may be
• Investigations :
CXR/CT chest : rounded opacity inside a cavity.
Raised aspergillus precipitins titer.
• Management :
Surgical resection : may be not possible due to bad lung function.
Bronchial artery embolisation : in severe haemoptysis.
Itraconazole : long course.
Intra-cavitary amphotricin : in some cases.
Chronic necrotizing pulmonary aspergillosis (CNPA)
- Slow spreading ,long-standing lung infection by aspergillus fungus.
- Usually affects people with an existing lung condition ,chronic liver disease, chronic
alcoholism or people with weak immune system e.g DM , chronic steroid ttt.
- Because it is uncommon, CNPA often remains unrecognized for weeks or months &
can cause a progressive cavitary pulmonary infiltrate.
• Management :
Itraconazole