Pulmonary aspergilloma and pulmonary tuberculosis: is there a strong association?

SESSION TITLE: Respiratory InfectionsSESSION TYPE: Slide PresentationsPRESENTED ON: Sunday, March 23, 2014 at 04:15 PM - 05:15 PMPURPOSE: Aspergillus spp. is a ubiquitous fungus and responsible for a broad spectrum of lung disease depending on the patient's immune status and underlying lung disease. Due to a preexisting lung cavity from a variety of causes, such as pulmonary tuberculosis, excavated lung cancer, sarcoidosis, or pneumoconiosis, aspergillus can colonize and grow into the cavity to form a pulmonary aspergilloma (fungus ball).

METHODS: We conducted a retrospective study in order to evaluate the frequency of intracavitary aspergilloma on underlying lung disease and also to evaluate the efficiency of surgical interventions. 69 patients admitted in "Leon-Daniello" Pneumology Clinical Hospital in the last 20 years, with suspicion of aspergilloma were evaluated.

RESULTS: From those 49 (71.01%) were males and 20 (28.98%) were females, mean age was 57.38±10.52. In 5/69 (7.24%) cases the primary diagnosis was pulmonary adenocarcinoma, 4/69 (5.79%) was sarcoidosis, 1/69 (1.44%) was pneumoconiosis and in the rest of the cases 59/69 (85.50%), intracavitary aspergilloma was present on sequelare lesions and also with active bacillary lesion. A significant statistical correlation was found for the development of aspergilloma on a preexisting pulmonary tuberculosis (p<0.00001), especially for sequelare lesions (p<0.0001). Surgical therapy was applied in 40 cases (57.97%) using lobe exeresis, atypical resection and cavernoplasty. One year post surgical treatment, 32 (77.5%) cases had a favorable evolution and the other cases were lost of follow-up.

CONCLUSIONS: The pulmonary aspergilloma develops most commonly on an underlying disease such as pulmonary tuberculosis, especially sequelare tuberculosis cavities.

CLINICAL IMPLICATIONS: As clinicians, we need to direct our attention to a most carefull monitoring of patients with pulmonary sequelare tuberulosis, even screening methods, due to the high risk of developing pulmonary aspergillosis.

DISCLOSURE: The following authors have nothing to disclose: Doina Adina Todea, Paraschiva Postolache, Loredana Elena Rosca, Andreea Codruta ComanNo Product/Research Disclosure Information.