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Suggest Treatment For Pulmonary Aspergilliosis

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Posted on Fri, 27 Jun 2014
Question: I am suffering from pulmonary aspergilliosis and voriconazole use for 10 weeks has not yielded any good result. is there any other treatment for this condition?
doctor
Answered by Dr. Gyanshankar Mishra (16 minutes later)
Brief Answer:
Medical management is not definitive.

Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query, I would like to comment the following:

1. Pulmonary aspergillosis is fungal infection of the lung. The most common presentation that we see is that of a fungal ball or aspergilloma. It would be helpful if you could tell your xray chest or ct scan thorax findings so as to know the exact nature of pulmonary aspergillosis in your case.

2. In cases of pulmonary aspergilloma , a 12 weeks course of voriconazole may be given but definitive radiological response may or may not be seen. If an aspergilloma is not causing any problems like recurrent infections, hemoptysis (blood in coughing) etc. then it may be left alone but oif symptoms are distressing then surgical removal of the same is an option and you may be referred by your pulmonologist to a CVTS (thoracic) surgeon.

I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.

Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Gyanshankar Mishra (31 minutes later)
There is no blood in coughing there is no infections. It a small mass on the right lung.We have done CT scanning, PET scanning and no definite results. What do you suggest.
doctor
Answered by Dr. Gyanshankar Mishra (2 hours later)
Brief Answer:
It seems to be aspergilloma.

Detailed Answer:
Hi,
Thanks for the follow up info. After going through the follow up info, I would like to comment the following:

1. You seem to be suffering from pulmonary aspergilloma.
2. Normally a 12 weeks course of voriconazole may be prescribed in such cases. But the definitive treatment is surgical removal.
3. In absence of any symptoms surgery is not indicated at present. It needs to be under regular medical observation. You need to have regular follow ups in future with your physician.

I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.

Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gyanshankar Mishra (9 hours later)
how would you rate a surgery on aspergillioma and is there a web site one can access other people who have experienced the same?
doctor
Answered by Dr. Gyanshankar Mishra (47 minutes later)
Brief Answer:
Surgery is not without risks.

Detailed Answer:
Hi,
Thanks for the follow up query. After going through the follow up query, I would like to comment the following:

1. Asymptomatic aspergilloma may be left as it is unless recuuring symptoms are present.

2. Surgery for aspergilloma is curative but surgery is not without risks eg. post surgical infection, decreased lung capacity ,etc.

3. you may visit this website:
http://www.nacpatients.org.uk/

I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.

Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

Answered : 600 Questions

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Suggest Treatment For Pulmonary Aspergilliosis

Brief Answer: Medical management is not definitive. Detailed Answer: Hi, Thanks for posting the query on HCM. After going through your query, I would like to comment the following: 1. Pulmonary aspergillosis is fungal infection of the lung. The most common presentation that we see is that of a fungal ball or aspergilloma. It would be helpful if you could tell your xray chest or ct scan thorax findings so as to know the exact nature of pulmonary aspergillosis in your case. 2. In cases of pulmonary aspergilloma , a 12 weeks course of voriconazole may be given but definitive radiological response may or may not be seen. If an aspergilloma is not causing any problems like recurrent infections, hemoptysis (blood in coughing) etc. then it may be left alone but oif symptoms are distressing then surgical removal of the same is an option and you may be referred by your pulmonologist to a CVTS (thoracic) surgeon. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist