Fungus ball: Clinical presentation, diagnosis and treatment in 31 cases

Background: Clinical presentation, diagnosis and treatment, and outcome of pulmonary Fungus ball have been known to depend on the underlying lung disease. We described clinical findings, diagnosis and results of surgical treatment of Fungus ball. Methods: From 1992 to 2005, we operated 31 patients with aspergilloma. Among them, 18 were male with a median age of 52 (30 to 70 years). 11 were afflicted with simple aspergiolloma and the rest with complex aspergiolloma. Results: Hemoptysis and cough were the most complaints. Diagnostic tools were CXR and CT scan. Tuberculosis and Bronchectasis were the most common underlying lung diseases. 39 procedures were performed in the patients. The most common surgical procedures were Lobectomy, wedgresection and closed tube cavernostomy with amphotericin installation in the cavity. The most common postoperative complications in the complex type were bronchopleural fistula, empyema and persistent space. Intraoperative mortality occurred in two cases because of bleeding during one to four year follow-up. Eight patients died because of sepsis and respiratory failure. Conclusions: Because of the underlying lung disease, postoperative complications and mortality rate were high especially in complex aspergiolloma. However, surgery is the approach of choice in these patients. In high-risk patients, tube cavernostomy could be helpful.