| Aspergilloma by D.W. Denning |
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| The vast majority of fungal balls in the lungs are due to Aspergillus with rare cases due to Pseudallescheria boydii or Mucorales. This discussion will focus on aspergillomas. The risk of developing an aspergilloma within a cavity of =2cm in diameter is 15-20% Approximately 10% of aspergillomas resolve spontaneously making uncontrolled observations in small numbers of patients difficult to interpret. Distinguishing chronic invasive aspergillosis from genuine aspergillomas is important because the former require systemic antifungal therapy. In the recent report of aspergillomas in AIDS (Addrizzo-Harris et al, 1997), progression of aspergillomas over time was seen with considerable morbidity and some mortality. This probably reflects invasion of cavity walls by Aspergillus rather than simple colonisation of Pneumocystis cavities by Aspergillus. more... |