Case 077: Pneumonia causing lung cavitation and aspergilloma - removed by surgery.
Summary:

This 43 year old man had life-threatening pneumococcal pneumonia requiring 3 weeks intensive care and a tracheostomy. The affected area of lung cavitated. About 12 months later, he re-presented with recurrent chest infections and a fungal ball was seen in the area of cavitation on CT scan. This was removed surgically via a right upper lobectomy. He remains well 6 months later.

Comments:

Diagnosis:
The combination of a single cavity with material resembling a ball, combined with positive blood Aspergillus precipitins (IgG antibodies) is characteristic of an aspergilloma.

Management:
As the area affected was relatively circumscribed, and his general respiratory function was good, surgical resection is the best choice. This was done under epidural. He recovered well from surgery.

Outcome:
Cure (at 6 months post-operatively).

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