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Submitted: 19 May 2016 Modified: 19 May 2016
HERDIN Record #: NCR-PHC-16051917225492

Life Threatening Hemoptysis: a case of chronic cavitary pulmonary tuberculosis complicated with Aspergilloma.

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Background: Pulmonary Aspergilloma is a rare disease, usually presenting as secondary invasion of preexisting lung cavity. When a pre-existing lung cavity is colonized by Aspergillus fumigatus it forms a fungal ball known as Pulmonary Aspergilloma.


Case Study: This is a case of a 23 year-old female with past history of tuberculosis presented productive cough, respiratory distress, generalized body weakness and hemoptysis for two years. On initial investigation Chest X-Ray revealed Cavitary PTB in the left upper lobe and Sputum AFB showed Positive. She was managed as case of Pulmonary Tuberculosis and was given Anti-Koch's medication for 6 months. However there was recurrence of productive cough and hemoptysis. On subsequent investigation, repeat Chest X-Ray revealed fibro-nodular density in the left upper lobe. Repeat Sputum AFB showed negative. Chest CT scan with contrast showed a radiological findings of a ball-like structure within pre-existing lung cavity on the left upper lobe and a consideration of PTB versus Aspergilloma was made. Patient was then referred to a Pulmonologist and was advised surgery.


Conclusion: Surgical treatment of Pulmonary Aspergilloma is the most effective treatment; surgical resection of the cavity and removal of the fungus ball is the treatment of choice when indicated and in recurrent hemoptysis, if their pulmonary function is sufficient to allow surgery.

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Philippine Heart Center Medical Library CR.027.15 Fulltext Print Format

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