Archivos de Medicina Interna
Print version ISSN 0250-3816
Summary The Aspergilloma (“fungus ball”) is one of the clinical forms of pulmonary aspergilosis, due to several Aspegillus spp. growing in ectatic bronchi and pre-existing pulmonary cavities.In our clinical case there was a previous history of pulmonary tuberculosis which, after a controlled and complete specific therapy, left a permanent and severe pulmonary fibrotic sequelae with bilateral big cavernae and clinical respiratory insufficiency. The massive hemoptysis and severe respiratory failure requiring critical care and the unusual topography of the images of the bilateral Aspergilloma make it interesting in this case The microbiological studies in the respiratiry secretions confirmed the diagnosis (Aspergillus fumigatus) and an intercurrent bacterial co-infection. The conventional anti-mycotic drugs are not effective for aspergilloma erradication. Surgical therapy, sometimes definitive, was not indicated here due to evident clinical respiratory distress. The revised medical literature showed alternative forms of therapy (less invasive but less successful) for the resolution of patients of this kind.
Keywords : Bilateral Aspergilloma ; tuberculous cavernae; hemoptysis; itraconazole; therapy.