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Updated: May 16, 2026
09:52
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Multifocal pulmonary aspergillomas: case series and review
Matthew Pendleton1, David W Denning
1Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom.
Annals of the New York Academy of Sciences
|December 13, 2012
Summary
Multiple fungal balls in lung cavities, a new sign of chronic pulmonary aspergillosis (CPA), were found in five patients. This finding presents challenges in managing azole resistance and treatment outcomes.
Area of Science:
- Pulmonology
- Mycology
- Infectious Diseases
Background:
- Chronic pulmonary aspergillosis (CPA) is typically characterized by single or few lesions.
- Multifocal lung cavities with multiple fungal balls are not widely recognized as a CPA manifestation.
Observation:
- Five patients with CPA presented with multiple (3-11) thin-walled cavities or nodules containing fungal balls.
- These lesions were primarily intraparenchymal with minimal pleural involvement.
- Patients had underlying conditions like asthma or cystic fibrosis and corticosteroid exposure.
Findings:
- Four patients showed elevated Aspergillus IgG, and one had elevated Aspergillus-specific IgE.
- Three patients developed azole resistance after initial treatment response.
- One patient underwent lung transplant, later experiencing a fatal mycotic cerebral aneurysm.
Implications:
- Multiple aspergillomas represent a distinct and underrecognized manifestation of CPA.
- The lack of inflammatory response and unique distribution of cavities are notable.
- Management of azole resistance and treatment strategies for this presentation require further investigation.
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