Aspergillus of the lung with haemoptysis: A surgical emergency

Abstract

Background: Aspegillus is an important pathogen in patients with impaired host defences. These mycelial fungi can cause local as well disseminated disease. Two forms of pulmonary aspergillosis are frequently seen : 1. pulmonary or brochial aspergilloma (fungus ball) due to secondary invasion of a a tuberculous cavity and 2. allergic bronchopulmonary aspergilosis. The aim study was to evaluate the outcome of surgical management in patients with Aspergillomas of the lung with recurrent and severe Haemoptysis.

Methods: Eight patients were treated surgically for Aspergillomas of the lung; six of them in Maputo Central Hospital and the other two in Medina Hospital in Somalia. These Aspergillums lesions were located in the upper lobe as a fungal ball. In five of the patients the lesions were located in the right upper lobe while in the other three the left upper lobe was involved. In Maputo Central Hospital, investigations done in all six patients included the plain chest X-rays, CT scans, bronchoscopy and common laboratory exams. The two patients in Medina Hospital had only plain X-rays and common laboratory exams. All the eight patients had upper lobectomy. No intrathoracic contamination occurred during surgery.

Results: Eight patients with recurrent and severe Haemoptysis had surgical treatment (upper lobectomies) without intrathoracic contamination. All the patients had an average of ten days of postoperative hospital.

Complications: One patient has died for postoperative haemorrhage among those patients treated in Maputo Central Hospital.

Conclusion: Our limited experience of 8 patients showed that surgical treatment is effective and leads to a complete recovery and rehabilitation of the patient