KUMJ | VOL. 14 | NO. 2 | ISSUE 54 | APR-JUN. 2016
A Rare Case of Bilateral Aspergillomas in a Patient of Ankylosing Spondylitis
Das A, Pandit S, Das SK, Basuthakur S, Das S
Abstract: Pulmonary involvement by Aspergillus sp. mainly includes allergic
bronchopulmonary aspergillosis, aspergilloma, and invasive aspergillosis.
Aspergilloma (Fungal ball) is the most common form of aspergillous pulmonary
involvement, which occurs in preexisting pulmonary cavities, especially secondary
to pulmonary tuberculosis. Ankylosing spondylitis is a rare cause of upper lobe
fibro-cavitary lesions in pulmonary parenchyma. It may also lead to development
of fungal balls in pulmonary cavities. Most common presentation is mild to massive
hemoptysis; dyspnoea, chronic cough, expectoration may be other presentation;
even the patient may remain asymptomatic. Intaracavitary mobile mass is a
valuable sign for fungal ball, best detected by computed tomography (CT) scan of
thorax. Lobectomy is the treatment of choice to stop the hemoptysis, if the general
condition of the patient is fit; otherwise associated co-morbidities complicate the
post-operative scenario. In this situation, bronchial artery embolization may be
used as a temporary measure to control hemoptysis. Here, we report a case of
bilateral aspergillomas within the cavities located in upper lobes of both lungs in a
74 years old male who was suffering from ankylosing spondylitis for last 42 years.
Keyword : Aspergilloma, ankylosing spondylitis, hemoptysis, lobectomy
