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Review
. 2024 Oct 11;18(1):491.
doi: 10.1186/s13256-024-04801-y.

Bilateral chronic cavitary pulmonary aspergillomas in an adult patient with recurrent tuberculosis: a case report and literature review

Telila Mesfin Tadesse  1 , Oliyad Shegene  2 , Sisay Dadi Abebe  3 , Eshetu Mesfin Tadesse  4 , Biniyam Sahiledengle  5 , Mesfin Tsegaye Jima  2
Affiliations
Review

Bilateral chronic cavitary pulmonary aspergillomas in an adult patient with recurrent tuberculosis: a case report and literature review

Telila Mesfin Tadesse et al. J Med Case Rep. .

Abstract

Background: Aspergillomas are globular growths of Aspergillus fumigatus, a benign aspergillosis of the lungs. It usually affects patients who are immunocompromised and have anatomically defective lung structures. The majority of aspergilloma cases are asymptomatic, despite the fact that 10% of cases spontaneously resolve. Most patients do not have any symptoms from their lesions. Direct serological or microbiological evidence of an Aspergillus species along with radiologic evidence is required for the diagnosis of an aspergilloma.

Case: We describe a 35-year-old adult Oromo male patient who had been experiencing night sweats, an intermittent productive cough with sparse whitish sputum, loss of appetite, and easy fatigability for 3 months. At 5 years prior, he received treatment for pulmonary tuberculosis that was smear-positive and was subsequently certified healed. Objectively, he was tachypneic and had intercostal, subcostal, and supraclavicular retractions with symmetric chest movement. A high-resolution computed tomography scan revealed bilateral apical cavitary lesions with core soft tissue attenuating spherical masses and an air crescentic sign suggestive of aspergillomas, which were confirmed by sputum light microscopic examination. The patient was managed with antibiotics and antifungals.

Conclusion: Aspergilloma is a symptom of chronic pulmonary aspergillosis, a category of lung disorders caused by a persistent Aspergillus infection. Primary aspergillomas are uncommon and frequently occur in people with compromised immune systems. A prolonged cough, fever, chest pain, and hemoptysis are all symptoms of pulmonary aspergillomas. The majority of the time, pulmonary aspergillosis is difficult to identify. Despite high mortality and morbidity rates, surgery is still the most effective treatment for pulmonary aspergilloma.

Keywords: Aspergilloma; Aspergillus fumigatus; Post tuberculosis; Pulmonary aspergilloma; Tuberculosis recurrence.

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Conflict of interest statement

We declare that there are no competing interests.

Figures

Fig. 1
Fig. 1
A Postero-anterior (PA) chest x-ray showing bilateral upper lobe old fibrotic changes, bilateral upper lung zone pulmonary nodules and left pleural effusion
Fig. 2
Fig. 2
A high resolution chest Computed tomography (CT) scan showing an air crescent sign
Fig. 3
Fig. 3
A chest Computed tomography (CT) scan image showing left lung consolidation with bilateral lower lobe ground glass opacities and left pleural collection
See this image and copyright information in PMC

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