Chronic cavitatory aspergilloma in an old emaciated patient with review of three cases

Pulmonary aspergilloma (fungal ball or intra-cavitatory mycetoma) is aspergillus infection of pre-existing cystic or cavitatory lung disease. The saprophytic fungal hyphae grow on the cavity wall, peel off and form a fungal ball, mixed with blood products and cellular debris. 1 Residual tubercular cavities are most commonly involved, 2 though pulmonary cavity of sarcoidosis, lung cysts, bullae, cavitated bronchogenic carcinoma, pulmonary infarction and apical fibrosis of ankylosing spondylitis may also harbour aspergilloma. 3 Cases of aspergilloma with no previous lung disease have also been reported. Other fungi causing aspergilloma are Allescheria boydii, Fusarium species and Zygomycetes. Identification of fungi is important for medical treatment, as Allescheria boydii does not respond to amphotericin B. 4 Presented here is a case of aspergilloma with chronic cavitatory lesion developing in a patient with no previous lung disease.