Surgical treatment of pulmonary aspergilloma.

Fourteen patients with aspergilloma (fungus ball) were reviewed. Hemoptysis was the major symptom (93%). Chest roentgenograms disclosed a "fungus ball" in every patient, and the mycelia of Aspergillus fumigatus were recovered from all resected specimens. One of three patients treated by pneumonectomy died post-operatively. A lobectomy was performed in ten patients, and segmental resection in one without mortality or significant morbidity. There has been no evidence of recurrence in a follow up of six months to ten years. On the basis of this experience and a review of the literature, excision of a solitary "fungus ball" is recommended when the diagnosis is made. Non-surgical therapy should be reserved for patients whose general medical status or pulmonary reserved prohibit resection.

Diphtheroid endocarditis after aortic valve replacement.

Diphtheroid endocarditis after aortic valve replacement was cured with penicillin, gentamycin and erythromycin. Infections occur most commonly on the aortic valves of men patients within two weeks after prosthetic insertion. Management with combined drug therapy based on sensitivities and clinical response are suggested. Paravalvular leaks do not necessarily require valve replacement.