Surgical treatment of pulmonary aspergilloma

Fourteen patients with aspergilloma (fungus ball) were reviewed. Hemoptysis was the major symptom (93%). Chest roentgenograms disclosed a "fungus ball" in every patient, and the mycelia of Aspergillus fumigatus were recovered from all resected specimens. One of three patients treated by pneumonectomy died post-operatively. A lobectomy was performed in ten patients, and segmental resection in one without mortality or significant morbidity. There has been no evidence of recurrence in a follow up of six months to ten years. On the basis of this experience and a review of the literature, excision of a solitary "fungus ball" is recommended when the diagnosis is made. Non-surgical therapy should be reserved for patients whose general medical status or pulmonary reserved prohibit resection.