CGH Residents Round

Ubiquitous soil-dwelling organism Primarily acquired from an inanimate reservoir, usually by the inhalation of airborne spores.

Aspergillus niger

Aspergillus fumigatus

Inhalation of Aspergillus spores

Colonisation

Normal Host

Cavitatory Lung Disease

Chronic Lung Disease or Mild ICH

Immunocompromised Host

Asthma

No Sequele

Aspergilloma

Chronic Necrotizing Aspergillosis

Invasive Pulmonary Aspergillosis

Allergic Bronchopulmonary Aspergillosis

consists of masses of fungal mycelia, inflammatory cells, fibrin, mucus, and tissue debris usually in a preformed lung cavity Predisposing conditions
TB, sarcoidosis, bronchiectasis, bronchial cysts

and bullae, neoplasm, or pulmonary infarction.

Clinical symptoms
Asymptomatic Haemoptysis

Chronic cough
Dyspnoea

Diagnosis
History and examination Imaging
An upper-lobe, mobile, intracavitary mass with an air crescent in the periphery Change in the position of the aspergilloma with a change of position of the patient

Sputum
may reveal the presence of Aspergillus but is negative in 50% of

the cases

Serology
Serum IgG antibodies to Aspergillus

Skin reactivity

Treatment

Conservative bed rest, humidified oxygen Medical Topical antifungal inhaled, intracavitary, endobronchial Systemic antifungal Interventional Bronchial artery embolization Surgical

Surgical
Pros: Only definitive treatment that eradicates the disease

Cons Only suitable if patients pulmonary function is sufficient to allow surgery High operative mortality and morbidity rates