The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance

Ebbi Donald Robinson

doi:doi:10.11648/j.ijmi.20200803.13

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The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance

Ebbi Donald Robinson

Published in International Journal of Medical Imaging (Volume 8, Issue 3)

Received: 18 September 2020 Accepted: 29 September 2020 Published: 12 October 2020

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Abstract

Mycetoma or fungus ball is a clump of mould which exists in the human body cavity caused by fungi of the genus Aspergillius. Simple aspergillomas are often asymptomatic however it can clinically present with Cough, haemoptysis and wheezing. The study was aimed at documenting the evolution of pulmonary tuberculosis (PTB) to pulmonary aspergiloma in patients with long-standing pulmonary tuberculosis. Chest radiographs and computed tomographic (CT) scans were evaluated to demonstrate the evolution of pulmonary tuberculosis to aspergiloma. The initial chest radiograph showed inhomogeneous opacities in the left upper lung zone with backgrounds nodular and streaky changes. Subsequent chest radiographs demonstrated thick walled cavitary lesion with an oval shaped mass within it having a surrounding crescentic halo. A plan radiologic diagnosis of pulmonary tuberculosis with subsequent development of pulmonary aspergiloma was made. Follow up contrast enhanced axial section chest CT scan showed a fairly well-defined non-enhancing iso-hyperdense lesion with a surrounding halo giving the air crescent sign at the left upper lung zone. Aspergiloma can be seen on both plain radiographs and computed tomograms. Mr A.D., a 49 year old male who presented with a history of cough of three weeks duration. The cough is productive of sputum and haemoptysis. He has taken anti-PTB drugs 4 times but is still presenting with cough due to pulmonary aspergiloma secondary to previous pulmonary tuberculosis, thus a need for radiologic pulmonary vigilance.

Published in	International Journal of Medical Imaging (Volume 8, Issue 3)
DOI	10.11648/j.ijmi.20200803.13
Page(s)	49-53
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pulmonary Tuberculosis, Pulmonary Aspergiloma, Fungal Ball, Cavitary Lung Lesion, Port Harcourt

References

[1]	Patterson, TF. (2009). Aspergillus Species. In Principles and Practice of Infectious Diseases. 7th edition. Elsevier Churchill Livingstone, Philadelphia. Pp 258.
[2]	Henry Knipe and Frank Gaillard. Aspergilloma. https://radiopaedia.org/articles/aspergilloma. Retrieved 27^th September 2020.
[3]	Quan, C., Spellberg, B. (2010) Mucormycosis peudallescheriasis and other uncommon mould infections. Proc Am Thorac Soc; 7 (3): 210–215.
[4]	Soubani, AO., Chandrasekar, PH. (2002) The Clinical Spectrum of Pulmonary Aspergilosis. Chest; 121 (6): 1988–1989.
[5]	David, WD., Alex, P., Donald, CC., (2011) Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis. Bull World Health Organ. 89 (12): 864–872.
[6]	Pulmonary aspergilloma. https://medlineplus.gov/ency/article/000127.htm Retrieved 27th September 2020
[7]	Maheshwari, V., Varshney, M., Alam, K., Khan, R., Jain, A., Gaur, K., & Bhargava, R. (2011). Aspergilloma lung mimicking tuberculosis. BMJ case reports, 2011, bcr0420114051. https://doi.org/10.1136/bcr.04.2011.4051
[8]	Gaspari, AA., Tyring, SK., Clinical and Basic Immunodermatology. Springer. 2008.
[9]	Anaissie EJ, McGinnis MR, Pfaller MA. Clinical Mycology. Churchill Livingstone. 2009.
[10]	Soto Guerrero Y., Hernandez Castillo A., Jaume Anselmi F., Vélez Santiago A., Ramírez Rivera J. (2012). Radiographical vignette: an apical lung density in an elderly man with hemoptysis. Bol Asoc Med P R. 104 (2): 82-4. PMID: 23882981.
[11]	Khan, B., Ansari, M., Shrestha, D., Pradhan, S. (2006) A case report on Pulmonary Aspergiloma. The Internet Journal of Radiology. 2006;(6): 8687-8691.
[12]	Oladele R., Denning D. (2014) Burden of serious fungal infection in Nigeria. West African journal of medicine 33 (2): 107-14.
[13]	Lee SH, Lee BJ, Jung DY, Kim JH, Sohn DS, Shin JW, et al. (2004) Clinical manifestations and treatment outcomes of Pulmonary Aspergilloma. Korean J Intern Med.; 19 (1): 38-42.
[14]	Müller NL, Franquet T, Lee KS, Silva CIS. (2007) Viruses, mycoplasma, and chlamydia. In: Imaging of Pulmonary Infections. Lippincott Williams & Wilkins. Philadelphia; P94.
[15]	Chen JC, Chang YL, Luh SP, Lee JM, Lee YC. (1997) Surgical treatment for Pulmonary Aspergilloma: a 28 year experience. Thorax.; 52 (9): 810-813.
[16]	Franquet, T., Müller, NL., Giménez, A., Guembe, P., Torre, J., Bague, S. (2001) Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics. 21 (4): 825-837.
[17]	Collins, J., Stern, EJ.. Chest radiology, The essentials. Lippincott Williams & Wilkins. 2007.
[18]	Kathuria, H., Hollingsworth, H.M., Vilvendhan, R. & Reardon C. (2020). Management of life-threatening hemoptysis. j intensive care 8, 23. https://doi.org/10.1186/s40560-020-00441-8
[19]	Gazzoni FF., Severo LC., Marchiori E., Guimarães MD., Garcia TS., Irion KL., Camargo JJ., Felicetti JC., de Mattos Oliveira F., Hochhegger B. (2014). Pulmonary diseases with imaging findings mimicking aspergilloma. Lung. 192 (3): 347-57. doi: 10.1007/s00408-014-9568-7.
[20]	Kawamoto H., Suzuki M., Shiozawa A., Miyawaki E., Yamamoto S., Kobayashi K., Takasaki J., Takeda Y., Hojo M., Sugiyama H. (2018). Massive Hemoptysis with a Fungus Ball-like Shadow in an Old Tuberculosis Cavity That Was Shown to Be a Clot by Bronchoscopy. Intern Med. 57 (3): 377-381. doi: 10.2169/internalmedicine.8967-17.

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APA Style

Ebbi Donald Robinson. (2020). The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance. International Journal of Medical Imaging, 8(3), 49-53. https://doi.org/10.11648/j.ijmi.20200803.13

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ACS Style

Ebbi Donald Robinson. The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance. Int. J. Med. Imaging 2020, 8(3), 49-53. doi: 10.11648/j.ijmi.20200803.13

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AMA Style

Ebbi Donald Robinson. The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance. Int J Med Imaging. 2020;8(3):49-53. doi: 10.11648/j.ijmi.20200803.13

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@article{10.11648/j.ijmi.20200803.13,
  author = {Ebbi Donald Robinson},
  title = {The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance},
  journal = {International Journal of Medical Imaging},
  volume = {8},
  number = {3},
  pages = {49-53},
  doi = {10.11648/j.ijmi.20200803.13},
  url = {https://doi.org/10.11648/j.ijmi.20200803.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20200803.13},
  abstract = {Mycetoma or fungus ball is a clump of mould which exists in the human body cavity caused by fungi of the genus Aspergillius. Simple aspergillomas are often asymptomatic however it can clinically present with Cough, haemoptysis and wheezing. The study was aimed at documenting the evolution of pulmonary tuberculosis (PTB) to pulmonary aspergiloma in patients with long-standing pulmonary tuberculosis. Chest radiographs and computed tomographic (CT) scans were evaluated to demonstrate the evolution of pulmonary tuberculosis to aspergiloma. The initial chest radiograph showed inhomogeneous opacities in the left upper lung zone with backgrounds nodular and streaky changes. Subsequent chest radiographs demonstrated thick walled cavitary lesion with an oval shaped mass within it having a surrounding crescentic halo. A plan radiologic diagnosis of pulmonary tuberculosis with subsequent development of pulmonary aspergiloma was made. Follow up contrast enhanced axial section chest CT scan showed a fairly well-defined non-enhancing iso-hyperdense lesion with a surrounding halo giving the air crescent sign at the left upper lung zone. Aspergiloma can be seen on both plain radiographs and computed tomograms. Mr A.D., a 49 year old male who presented with a history of cough of three weeks duration. The cough is productive of sputum and haemoptysis. He has taken anti-PTB drugs 4 times but is still presenting with cough due to pulmonary aspergiloma secondary to previous pulmonary tuberculosis, thus a need for radiologic pulmonary vigilance.},
 year = {2020}
}

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TY - JOUR
T1 - The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance
AU - Ebbi Donald Robinson
Y1 - 2020/10/12
PY - 2020
N1 - https://doi.org/10.11648/j.ijmi.20200803.13
DO - 10.11648/j.ijmi.20200803.13
T2 - International Journal of Medical Imaging
JF - International Journal of Medical Imaging
JO - International Journal of Medical Imaging
SP - 49
EP - 53
PB - Science Publishing Group
SN - 2330-832X
UR - https://doi.org/10.11648/j.ijmi.20200803.13
AB - Mycetoma or fungus ball is a clump of mould which exists in the human body cavity caused by fungi of the genus Aspergillius. Simple aspergillomas are often asymptomatic however it can clinically present with Cough, haemoptysis and wheezing. The study was aimed at documenting the evolution of pulmonary tuberculosis (PTB) to pulmonary aspergiloma in patients with long-standing pulmonary tuberculosis. Chest radiographs and computed tomographic (CT) scans were evaluated to demonstrate the evolution of pulmonary tuberculosis to aspergiloma. The initial chest radiograph showed inhomogeneous opacities in the left upper lung zone with backgrounds nodular and streaky changes. Subsequent chest radiographs demonstrated thick walled cavitary lesion with an oval shaped mass within it having a surrounding crescentic halo. A plan radiologic diagnosis of pulmonary tuberculosis with subsequent development of pulmonary aspergiloma was made. Follow up contrast enhanced axial section chest CT scan showed a fairly well-defined non-enhancing iso-hyperdense lesion with a surrounding halo giving the air crescent sign at the left upper lung zone. Aspergiloma can be seen on both plain radiographs and computed tomograms. Mr A.D., a 49 year old male who presented with a history of cough of three weeks duration. The cough is productive of sputum and haemoptysis. He has taken anti-PTB drugs 4 times but is still presenting with cough due to pulmonary aspergiloma secondary to previous pulmonary tuberculosis, thus a need for radiologic pulmonary vigilance.
VL - 8
IS - 3
ER -

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Ebbi Donald Robinson

Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria

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APA Style

Ebbi Donald Robinson. (2020). The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance. International Journal of Medical Imaging, 8(3), 49-53. https://doi.org/10.11648/j.ijmi.20200803.13

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ACS Style

Ebbi Donald Robinson. The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance. Int. J. Med. Imaging 2020, 8(3), 49-53. doi: 10.11648/j.ijmi.20200803.13

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AMA Style

Ebbi Donald Robinson. The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance. Int J Med Imaging. 2020;8(3):49-53. doi: 10.11648/j.ijmi.20200803.13

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@article{10.11648/j.ijmi.20200803.13,
  author = {Ebbi Donald Robinson},
  title = {The Evolution of Pulmonary Tuberculosis to Pulmonary Aspergiloma in PortHarcourt: A Need for Radiologic Pulmonary Vigilance},
  journal = {International Journal of Medical Imaging},
  volume = {8},
  number = {3},
  pages = {49-53},
  doi = {10.11648/j.ijmi.20200803.13},
  url = {https://doi.org/10.11648/j.ijmi.20200803.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20200803.13},
  abstract = {Mycetoma or fungus ball is a clump of mould which exists in the human body cavity caused by fungi of the genus Aspergillius. Simple aspergillomas are often asymptomatic however it can clinically present with Cough, haemoptysis and wheezing. The study was aimed at documenting the evolution of pulmonary tuberculosis (PTB) to pulmonary aspergiloma in patients with long-standing pulmonary tuberculosis. Chest radiographs and computed tomographic (CT) scans were evaluated to demonstrate the evolution of pulmonary tuberculosis to aspergiloma. The initial chest radiograph showed inhomogeneous opacities in the left upper lung zone with backgrounds nodular and streaky changes. Subsequent chest radiographs demonstrated thick walled cavitary lesion with an oval shaped mass within it having a surrounding crescentic halo. A plan radiologic diagnosis of pulmonary tuberculosis with subsequent development of pulmonary aspergiloma was made. Follow up contrast enhanced axial section chest CT scan showed a fairly well-defined non-enhancing iso-hyperdense lesion with a surrounding halo giving the air crescent sign at the left upper lung zone. Aspergiloma can be seen on both plain radiographs and computed tomograms. Mr A.D., a 49 year old male who presented with a history of cough of three weeks duration. The cough is productive of sputum and haemoptysis. He has taken anti-PTB drugs 4 times but is still presenting with cough due to pulmonary aspergiloma secondary to previous pulmonary tuberculosis, thus a need for radiologic pulmonary vigilance.},
 year = {2020}
}

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