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Invasive Aspergillosis
My father (Age64) had a past history of Tuberculosis in 2013. Successfully did complete medication of 9 Month and no evidence of TB thereafter.
On 15th May he had cough with slight droplets of Blood. Since then, till today 25th 2020, sputum with blood not observed,
He is diabetic and currently taking antifungal Itraconazole 200 twice a day.
Sputum - Myco. Tuberculosis ----------- Not Detected
Galactomannan Serum ---------------2.04 (High)
Aspergillus IgG Antibody ------------14.64 (High)
Fungus Culture ----------------- Negative
Aspergillus IgM Antibody -------------4.6 Negative
IgE – Total Serum ------------------275 (High)
Blood Haemoglobin – 9.9 (Low)
X-ray – Fibrotic Calcification
CT Scan – Fibro-cavity changes with Fungal ball formation in the posterior segment of left upper lobe.
What should be our next approach.
Answers (4)
Aspergilloma can complicate an old tubercular cavity. Continue Itraconazole and consult pulmonologist for further management. Some people may need surgical removal if severe hemoptysis or any other complication . CT chest and Bronchoscopy may be required - but only after evaluated by pulmonologist , differ on case to case basis.
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At present is no active tuberculosis. The concern is aspergillosis ball in old.tubercular cavity that can cause blood in sputum. Continue antifungal as it. If blood comes recurent then further management should be surgical removal after the consultation with pulmonologist.
Next Steps
pulmonologist opinion
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Hello noted above history and related concerns.
As you must be aware of past history of TB and association of diabetes is poorly taken.
As for as current reports No TB and No blood in sputum .
Next Steps
Continue antifungal drugs along with other bronchodilators and diabetes medication
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