Chest
Selected ReportsBronchoscopic Removal of a Large Intracavitary Pulmonary Aspergilloma
Section snippets
Case Report
A 63-year-old woman with chronic obstructive pulmonary disease presented with a large (6.5 cm × 5.0 cm) aspergilloma (culture of BAL was positive for Aspergillus). Over the course of 3 years, the aspergilloma increased in size (Figs 1, 2), and the patient's symptoms of anorexia, weight loss, productive cough, chest discomfort, and hemoptysis progressed despite 12 months of itraconazole, followed by 2 months of voriconazole therapy. She was deemed unfit for surgery due to the risk of
Discussion
Intracavitary pulmonary aspergilloma is a potentially life-threatening problem characterized by mycelial growth in a preexisting lung cavity that is difficult to treat without surgical therapy, which is the accepted treatment of choice in appropriately selected patients. It does not respond to antifungal agents alone (including IV amphotericin B14), and mixed success has been obtained with inhaled, intracavitary, and endobronchial instillations of antifungal agents.4, 15, 16 Bronchial artery
Acknowledgments
Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Other contributions: This work was performed out of the Division of Respiratory Medicine, University of Calgary, Calgary, AB, Canada.
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