Pulmonary aspergillosis in chronic lung cavitary diseases

ABSTRACT

In this study, only one positive culture for Aspergillus fumigatus [1%] was detected, while the incidence of A. niger and A. flavus were 13% and 5%, respectively. Hemagglutination test showed a significant titer [1/320] in only 12 patients by using counter immunoelectrophoresis, serum of only one patient [1%] showed positive precepitation reaction against A. fumigatus antigen. None of these isolated aspergillus species showed a significant correlation with the underlying lung lesions [transient pulmonary aspergillus saprophytes] except A. fumigatus in one case suggesting aspergilloma. This type of A. fumigatus was found only in bronchoalveolar wash. However, clinical or histological diagnosis of any case of aspergilloma has never been confirmed. Therefore, this case of aspergilloma should be considered the first published Egyptian case. The proper diagnosis of such case and pulmonary aspergillosis still depends on competent mycological laboratory studies of patient's serum and bronchoalveolar wash samples. Surgical resection of aspergilloma affecting a lung lobe was the only way to save the patient from repeated hemoptysis attacks or other chest complications