Abstract
We report a patient with pulmonary aspergilloma in which a fungus ball was observed by bronchoscopy. An antimicrobial agent was infused into the chest cavity through an indwelling transcutaneous tube. The patient was an 83-year-old man who presented with hemoptysis. The chest X-ray film showed tumor shadows in the left lung apex and on bronchoscopy yellow-white protruding lesions occluded B^3 and the lingular division at the entrance to B^<1+2>. The biopsy specimen contained aspergillus hyphae and fungus bodies, confirming the diagnosis of aspergilloma. Based on the patient's wishes medical treatment was pursued. A combination of miconazole (30mg/day) and lidocaine (40mg/day) was infused for 97 consecutive days through the indwelling transcutaneous tube. Simultaneously, miconazole (200mg) was given intravenously twice a day. A follow-up bronchoscopy on day 119 disclosed a decrease in the size of the fungus ball, of the which 30mg miconazole was infused through the bronchoscope. The transcutaneous tube was removed 5 months after the treatment started. The treatment was considered effective since hemoptysis stopped and tumor shadows decreased on X-ray films.
