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pulmonary aspergilloma
ICD-10 Codes
Description
Pulmonary Aspergilloma: A Fungal Infection in the Lungs
Pulmonary aspergilloma, also known as fungus ball, is a type of fungal infection that affects the lungs. It is characterized by a mass or growth caused by a fungal infection, typically growing in lung cavities.
Causes and Symptoms
The infection can appear in various parts of the body, including the brain, kidney, or other organs, but it usually grows in lung cavities. The symptoms of pulmonary aspergilloma may include:
- A cough that often brings up blood (hemoptysis)
- Wheezing
- Shortness of breath
- Unintentional weight loss
- Fatigue
Development and Types
Aspergilloma develops when Aspergillus colonizes and grows inside lung cavities, forming a ball-like structure. Chronic necrotizing aspergillosis is a locally destructive form of the disease that can erode into the pleural surface and intercostal arteries, causing massive hemoptysis.
Pre-existing Conditions
Aspergilloma often develops in areas of past lung disease or lung scarring such as tuberculosis or lung abscess. It is considered a "saprophytic," or noninvasive, form of infection in which Aspergillus species colonizes pre-existing pulmonary cavities.
References:
- [1] Pulmonary aspergilloma is a mass caused by a fungal infection. It usually grows in lung cavities.
- [2] A rapidly growing cavity that can erode into the pleural surface and intercostal arteries, causing massive, often fatal hemoptysis highly ...
- [3] Oct 3, 2024 — Pulmonary aspergilloma is a mass caused by a fungal infection. It usually grows in lung cavities.
- [5] Aspergilloma · A cough that often brings up blood (hemoptysis) · Wheezing · Shortness of breath · Unintentional weight loss · Fatigue ...
- [9] Aspergilloma is considered a “saprophytic,” or noninvasive, form of infection in which Aspergillus species colonizes pre-existing pulmonary cavities.
Additional Characteristics
- Wheezing
- Shortness of breath
- Fatigue
- A type of fungal infection that affects the lungs
- A mass or growth caused by a fungal infection, typically growing in lung cavities
- A cough that often brings up blood (hemoptysis)
- Unintentional weight loss
- A 'saprophytic,' or noninvasive, form of infection in which Aspergillus species colonizes pre-existing pulmonary cavities
Signs and Symptoms
Pulmonary Aspergilloma Signs and Symptoms
Pulmonary aspergilloma, a type of fungal infection, can cause various signs and symptoms in affected individuals. These may include:
- Coughing (sometimes coughing up blood): This is one of the most common symptoms of pulmonary aspergilloma, often accompanied by bloody sputum [4][9].
- Shortness of breath (dyspnea): As the infection progresses, individuals may experience difficulty breathing, making it hard to perform daily activities [3][5].
- Noisy breathing (wheezing): Wheezing sounds can be heard when inhaling or exhaling due to airway obstruction caused by the fungal growth [3].
- Chest pain: Pain in the chest area may occur due to inflammation and scarring of lung tissue [4][9].
- Fever: Elevated body temperature is a common symptom, often accompanied by fatigue and weight loss [2][5].
In some cases, pulmonary aspergilloma can spread to other parts of the body, leading to additional symptoms such as:
- Fatigue: Feeling extremely tired or weak due to the infection's impact on overall health [4].
- Weight loss: Unintentional weight loss may occur as a result of chronic illness and decreased appetite [9].
It is essential for individuals experiencing these symptoms to consult their healthcare provider for proper diagnosis and treatment.
References:
[1] Aspergilloma. Certain chronic lung (pulmonary) conditions, such as emphysema, tuberculosis or advanced sarcoidosis, can cause air spaces (cavities) to form in the lungs. [2] Symptoms can vary depending on which parts of the body become infected. Other common symptoms include: Fever. Chest pain. Cough. Coughing up blood. Shortness of breath. [3] Coughing (sometimes coughing up blood). Shortness of breath (dyspnea). Noisy breathing (wheezing). Chest pain. Fever. Fatigue and weight loss can be symptoms of chronic pulmonary aspergillosis. [4] Aspergilloma is a growth (fungus ball) that develops in an area of past lung disease or lung scarring such as tuberculosis or lung abscess. [5] Symptoms · Chest pain · Cough · Coughing up blood, which can be a life-threatening sign · Fatigue · Fever · Unintentional weight loss ... [9] Oct 3, 2024. Signs.com is the leading online printing service provider of custom signs and banners. Create your vinyl banners, yard signs, metal signs, and more. FREE DESIGN SERVICES and ONE DAY PRODUCTION.
Additional Symptoms
- Coughing (sometimes coughing up blood)
- Noisy breathing (wheezing)
- weight loss
- chest pain
- dyspnea
- fever
- fatigue
Diagnostic Tests
Diagnostic Tests for Pulmonary Aspergilloma
Pulmonary aspergilloma, also known as fungus ball, is a type of lung infection caused by the fungus Aspergillus. The diagnosis of this condition typically involves a combination of imaging tests and laboratory examinations. Here are some of the diagnostic tests used to diagnose pulmonary aspergilloma:
- Imaging Tests: Chest X-rays or computerized tomography (CT) scans can show upper lobe predominant cavitation, which is a characteristic finding in patients with pulmonary aspergilloma [3]. A chest CT imaging is also considered a key element for diagnosis [2].
- Bronchoscopy and Bronchoalveolar Lavage (BAL): This procedure involves inserting a flexible tube through the mouth or nose to examine the airways. BAL can help collect samples from the lungs, which are then examined under a microscope for signs of infection [8].
- Blood Tests: Blood tests can help diagnose invasive aspergillosis early in people who have severely weakened immune systems [6]. Two types of blood tests are commonly used:
- Galactomannan antigen detection to detect the presence of Aspergillus in the body
- Specific antibodies for Aspergillus to detect the immune response to the fungus
- Culture: This involves taking samples from the respiratory tract and growing them in a laboratory to confirm the presence of Aspergillus [5].
- Histopathology: A biopsy of lung tissue can be examined under a microscope to confirm the diagnosis of pulmonary aspergilloma [8].
It's worth noting that a combination of these tests is often used to diagnose pulmonary aspergilloma, and not just one test alone.
Additional Diagnostic Tests
- Blood Tests
- Histopathology
- Culture
- Chest X-rays
- CT scans
- Bronchoscopy and Bronchoalveolar Lavage (BAL)
Treatment
Treatment Options for Pulmonary Aspergilloma
Pulmonary aspergilloma, a type of fungal infection in the lungs, can be challenging to treat. However, various antifungal medications have been shown to be effective in managing this condition.
- Voriconazole: Considered one of the most effective treatments for pulmonary aspergilloma, voriconazole (Vfend) has been shown to provide significant improvement in symptoms and lung function [1].
- Itraconazole: Oral itraconazole may offer partial or complete resolution of aspergillomas in up to 60% of patients [2]. However, its effectiveness can vary depending on individual cases.
- Amphotericin B: This antifungal medication is another option for treating pulmonary aspergilloma, although its use may be limited by potential side effects [1].
- Liposomal amphotericin B: A formulation of amphotericin B that can help reduce toxicity and improve treatment outcomes [6].
- Echinocandins: Caspofungin, an echinocandin, can be used in combination with voriconazole or other antifungal medications to enhance treatment efficacy [7].
Treatment Guidelines
Recent guidelines recommend the use of voriconazole and/or isavuconazole as primary treatments for invasive aspergillosis (IA), which includes pulmonary aspergilloma [3]. Liposomal amphotericin B is considered a first alternative in cases where intolerance or toxicity occurs.
In patients diagnosed with allergic bronchopulmonary aspergillosis, antifungal medications like itraconazole are commonly prescribed to manage symptoms and prevent disease progression [4].
References
[1] Context result 1: The most effective treatment is a newer antifungal drug, voriconazole (Vfend). Amphotericin B is another option.
[2] Context result 2: Jul 21, 2024 — Oral itraconazole may provide partial or complete resolution of aspergillomas in 60% of patients.
[3] Context result 3: by JD Jenks · 2018 · Cited by 159 — Recent guidelines recommend voriconazole and/or isavuconazole for the primary treatment of IA, with liposomal amphotericin B being the first alternative.
[4] Context result 4: If you are diagnosed with allergic bronchopulmonary aspergillosis, an antifungal medication, such as itraconazole, is the most common course of action.
[5] Context result 5: by F Maghrabi · 2017 · Cited by 75 — First line treatment is oral itraconazole or voriconazole. In the event of intolerance or toxicity, patients may be swapped from itraconazole to ...
[6] Context result 6: by TJ Walsh · 2008 · Cited by 18 — Therapeutic options include a change of class using an amphotericin B (AMB) formulation or an echinocandin, such as caspofungin (B-II); further use of azoles ...
[7] Context result 8: Jul 21, 2024 — Voriconazole is usually first-line therapy, sometimes in combination with other agents, such as caspofungin.
Recommended Medications
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Differential Diagnosis
Differential Diagnosis of Pulmonary Aspergilloma
Pulmonary aspergilloma, also known as fungus ball, is a type of fungal lung infection that can mimic other conditions. The differential diagnosis for pulmonary aspergilloma includes:
- Tuberculoma: A condition caused by tuberculosis that can present with similar symptoms to pulmonary aspergilloma [1].
- Carcinoma of the lung: Lung cancer can also be a consideration in the differential diagnosis, especially if the patient has a history of smoking or other risk factors [2].
- Coccidiomycosis: A fungal infection caused by Coccidioides immitis that can present with similar symptoms to pulmonary aspergilloma [3].
- Asthma: Patients with asthma may be more susceptible to developing pulmonary aspergilloma, and the condition can mimic severe asthma exacerbations [4].
- Bacterial pneumonia: Bacterial infections of the lung can also be a consideration in the differential diagnosis, especially if the patient has a history of recent respiratory illness [5].
- Atypical mycobacterial infection: Infections caused by atypical mycobacteria, such as Mycobacterium avium complex, can present with similar symptoms to pulmonary aspergilloma [6].
It's worth noting that the diagnosis of pulmonary aspergilloma is typically made through a combination of clinical presentation, imaging studies (such as CT scans), and histological examination of lung tissue. A definitive diagnosis can only be made by examining the fungus under a microscope.
References:
[1] RK Chakraborty (2022) - [2] MF Vuong (2023) - [3] S Raveendran (2018) - [4] M Kousha (2011) - [5] R Greene (2005)
Additional Differential Diagnoses
- Coccidiomycosis
- Atypical mycobacterial infection
- Tuberculoma
- lung carcinoma
- bacterial pneumonia
- asthma
Additional Information
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- An aspergillosis that presents as a clump of tangled mass of Aspergillus fungus fibres, blood clots, and white blood cells, which exists in the cavities of the lungs that develop in an area of previous lung disease or lung scarring.
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It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.