We investigated the clinical features of pulmonary aspergilloma with formation of a cavity caused by pulmonary Mycobavterium avium complex (MAC) disease during a follow-up period. Nine cased (6.2%) complicated by pulmonary aspergilloma were selected from among 146 patients with pulmonary MAC disease for the past seven years. The mean age of nine cases (four males, five females) was 70.1 years old. The average duration from the definite diagnosis of pulmonary MAC disease to the diagnosis of pulmonary aspergilloma was 36.0 months. Five patients received antituberculous therapy including clarithromycin (CAM) for pulmonary MAC disease, but this treatment was inffective in all cases and recurrence of lesions occurred after the end of treatment even when sputum conversion of MAC was achieved. Serological fungal examinations for anti-aspergillus IgG antibody were positive in all cases. The isolated mycosis was Aspergillus fumigatus in eight cases and Aspergillus niger in one. The characteristic radiological finding indicating the complication of pulmonary aspergilloma into a cavity previously caused by MAC was local thickening of the cavity wall without an obvious fungas ball. It is important during a long follow-up period to carry out for patients with pulmonary MAC disease a precise check of both transient radiological examinations using chest computed tomography and serological fungal examinations through this study.
Full conference title:
15th European Respiratory Society annual conference
- ERS 15th (2005)