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Pulmonary Aspergilloma

Last updated Jan. 4, 2019

Approved by: Maulik P. Purohit MD MPH

Pulmonary Aspergilloma is a form of fungal infection in which a fungal ball develops in the lung cavities. Typically, older males tend to be affected the most by this infection.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Aspergilloma of Lung
  • Fungus Ball due to Aspergillus

What is Pulmonary Aspergilloma? (Definition/Background Information)

  • Pulmonary Aspergilloma is a form of fungal infection in which a fungal ball develops in the lung cavities. Typically, older males tend to be affected the most by this infection
  • The cause of Pulmonary Aspergilloma is due to a fungus called Aspergillus. A major risk factor for infection is having certain underlying lung conditions, such as asthma or cystic fibrosis, and a weakened immune system
  • Most individuals with Pulmonary Aspergilloma do not show any significant symptoms, meaning they tend to be asymptomatic. In others, chest pain, unintended weight loss, and blood in cough may be seen
  • A possible complication of Pulmonary Aspergilloma is the spread of infection away from the lungs and lung bleeding (pulmonary hemorrhage), which can be dangerous
  • Pulmonary Aspergilloma tend to generally subside on its own most of the time; but, an individual may be prescribed antifungal medication, if the infection is severe
  • The prognosis of individuals with Pulmonary Aspergilloma mainly depends on the presence or absence of an underlying condition. In many individuals, the prognosis is typically good
  • The best way to prevent Pulmonary Aspergilloma is to avoid areas where the fungi grows and thrives, such as decaying vegetation piles

Who gets Pulmonary Aspergilloma? (Age and Sex Distribution)

  • Pulmonary Aspergilloma typically affects individuals between 50 and 60 years old
  • Both genders are affected, although a predilection for males is noted
  • All races and ethnic groups can be affected

What are the Risk Factors for Pulmonary Aspergilloma? (Predisposing Factors)

Individuals with the following risk factors have an increased chance for Pulmonary Aspergilloma:

  • Individuals with certain underlying lung conditions are at increased risk. These include:
    • Cystic fibrosis
    • Histoplasmosis
    • Coccidiodomycosis
    • Lung abscess
    • Lung cancer
    • Sarcoidosis
    • Tuberculosis
    • Asthma
  • Individuals with weakened immune systems such as:
    • HIV-positive individuals
    • Individuals on long-term corticosteroids

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pulmonary Aspergilloma? (Etiology)

Pulmonary Aspergilloma is caused by a fungus called Aspergillus.

  • It is formed when the fungus grows in a lung cavity, but does not invade the surrounding lung tissue
  • The most common type of fungus causing Pulmonary Aspergilloma is Aspergillus fumigatus

What are the Signs and Symptoms of Pulmonary Aspergilloma?

Most individuals affected by Pulmonary Aspergilloma may not show any symptoms of the disease. It may be diagnosed incidentally while performing imaging studies for other conditions. Some individuals may show the following signs and symptoms:

  • Chest pain
  • Cough with or without any sputum (phlegm)
  • Blood in cough
  • Unintentional weight loss
  • Fever
  • Tiredness/fatigue

The signs and symptoms of the underlying (lung) condition may also be seen.

How is Pulmonary Aspergilloma Diagnosed?

Pulmonary Aspergilloma is mostly diagnosed as an incidental finding, as many individuals do not show any symptoms. The healthcare physician might order the following tests and examinations to assist and confirm the diagnosis:

  • Blood tests: To detect antibodies specific to Aspergillus fungus
  • Chest X-ray
  • CT scan of the chest
  • Sputum culture and microscopy
  • Biopsy of lung tissue with culture studies
  • Bronchoscopy with cultures of bronchial washings

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pulmonary Aspergilloma?

Pulmonary Aspergilloma generally does not lead to any complications. In rare cases, it might result in any of the following complications:

  • The disease can spread to the adjoining part of lungs and other organs (a condition termed disseminated aspergillosis)
  • Severe difficulty in breathing, especially due to large-sized Aspergilloma of Lung
  • Bleeding from the lungs: If the lung mass involves a blood vessel, the individual can have massive bleeding in the lungs. It may result in coughing-up a significant amount of blood. This is a medical emergency and prompt medical attention should be provided
  • Surgical complications while removing the fungal ball

How can Pulmonary Aspergilloma be Treated?

Most individuals with Pulmonary Aspergilloma never develop any significant symptoms, and hence, no treatment may be required. Also, the fungal ball in the lung remains of the same size, in a majority of the cases. Sometimes, it may also regress or resolve spontaneously without any treatment.

In others, the following treatment measures may be considered:

  • If the individual is coughing-up blood, treatment is necessary
    • The individual might require emergency resuscitation by fluid and blood components, if the bleeding is large and severe
    • Antifungal medications may be used
  • Surgical resection of the affected cavity and removal of the fungal ball may be considered in case of severe or recurrent bleeding

How can Pulmonary Aspergilloma be Prevented?

The following can help prevent Pulmonary Aspergilloma:

  • Avoid places where aspergillus is found, especially if an individual has underlying lung infections or a weak immune system
  • Typically, Aspergillus grows on dead leaves, stored grains, compost pile, and decaying vegetation. Individuals with certain health conditions (poor immune systems) should avoid these areas

What is the Prognosis of Pulmonary Aspergilloma? (Outcomes/Resolutions)

The outcome of Pulmonary Aspergilloma varies and depends largely on the severity of the infection and the overall health of the individual. In many, the prognosis is good.

Nevertheless, the outcome may be poor in some individuals who have the following:

  • Severe underlying lung condition
  • Increasing size and/or number of fungal balls
  • Weakened immunity due to long-term usage of corticosteroids or due to HIV infection
  • Recurrent large volume blood in cough
  • Underlying severe sarcoidosis

Additional and Relevant Useful Information for Pulmonary Aspergilloma:

Please visit our Healthy Lungs Health Center for more physician-approved health information:

http://www.dovemed.com/healthy-living/healthy-lungs/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: July 10, 2017
Last updated: Jan. 4, 2019