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3 out of 7

Feature of aspergillus is? (AIIMS May 2010)

A A fungus ball within a pre-existing cavity

B Usually asymptomatic

C Hemoptysis

D All of the above

Ans. D

All of the above

Aspergilloma (mycetoma): A fungus ball within a pre-existing cavity (often caused by TB, sarcoidosis). It is usually asymptomatic but may cause cough, hemoptysis (may be torrential), lethargy, weight loss.


1). CXR. (Round opacity within a cavity, usually apical)

2). Sputum culture

3). Strongly positive serum precipitins Q;

4). Aspergillus skin test.

Treatment (only if symptomatic). Consider surgical Q excision for solitary symptomatic lesions or severe hemoptysis. Oral itraconazole Q and other antifungals have been tried with limited success.

Invasive aspergillosis: Risk factors

1). Immunocompromised, eg HIV, leukemia.

2). Burns,

3). WEGENER'S granulomatosis

4). SLE

5). After broad-spectrum antibiotic therapy.


1). Sputum culture

2). Serum precipitins;

3). CXR (consolidation, abscess).

4). Iv. Chest CT

5). Serial serum measurements of galacto mannan (an Aspergillus antigen) can be very helpful.

6). Diagnosis may only be made at lung biopsy Q or autopsy.

Treatment: Amphotericin Q B.