Clinical evaluation of 61 patients with pulmonary aspergilloma

Objective and Methods We retrospectively evaluated 61 cases with pulmonary aspergilloma representing patients admitted to Nagasaki University Hospital between January 1991 to June 1998. Results fifty-two (85%) were males and 9 (15%) were females, aged between 1 4 to 80 years (average, 65 years). Forty-four (72%) patients had history of old pulmonary tuberculosis. Chest radiographs showed "fungus ball" in the cavities in 42 (67%) cases while 16 (26%) cases showed thickening of the ca vity wall. Aspergillus fumigatus was isolated in 24 (39%) patients. Aspergi llus antigen or antibody was positive in 8 (13%) and 43 (70%) patients, res pectively. Oral itraconazole was used in 16 (26%) of patients, and surgical excision was performed in 15 (25%) patients. During hospitalization or aft er discharge, 19 (31%) patients died. Summary and Conclusion Pulmonary aspergilloma usually occurs in elderly pat ients with old tuberculosis and respiratory failure. Many cases did not res pond to antifungal therapy with itraconazole or amphotericin B, Our analysi s indicates that more effective and appropriate therapeutic regimens are ne eded for the treatment of patients with pulmonary aspergilloma.