Therapeutic difficulties of Aspergilloma

K.Bogus, A. Kdrolyi.


Aims:To analyse the therapeutic possibilities of Aspergilloma (A.) and to examine the efficiency of different treatments. Methods: A. patients were collected on the basis of data recording of Koranyi Institute in a 7 year-period. The case records were studied in detail. Results: From 1990 to 1996 52 A. cases were found. 27 patients underwent operation. 25 of them were symptomatic. The operation was carried out for therapeutic need in 20 cases, in 5 cases because of differential diagnostic problems and 2 patients were operated without any symptom. The surgical procedures were: 23 lobar resections, 2 pneumoctomies and 2 cavernostomies. Postoperative complications were observed in 12 cases, most frequently empyema (5). 15/52 patients were treated with different antifungal drugs e.g. fluconasol (1), itraconasol (3), Amphotericin B (5) and in 1 case endobronchial administration of Amphotericin B had been performed. In most of these cases the antifungal agents were not effective.As in the other patients concomitant diseases (e.g. COPD (11) and alcoholism (12)) were present, only symptomatic treatment had been used. Summary:More than 50% of all our patients underwent operation. The rate of postoperative complication was 41%. Antifungals were not effective in consequence of either short term treatment and/or poor patient tolerance. The definite treatment of A. is the operation, but the high rate of complications always necessitate an individual management.

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7th European Respiratory Society Annual Conference
    • ERS 17th (2007)