Images in Cardiothoracic Medicine and Surgery
Aspergilloma in a pneumonectomized cavity
Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(8) 991 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313495217 aan.sagepub.com
Walid Leonardo Dajer-Fadel, Rafael Borrego-Borrego and Rube´n Argu¨ero-Sa´nchez
Figure 1. (A) Coronal and (B) axial reconstructed computed tomography showing the fungus ball in the left apical pleural cavity. (C) The specimen after surgical resection.
A 59-year-old man with a history of left pneumonectomy due to congenital bullae nine years earlier, presented to our institution with cough of five months’ duration, associated with a purulent discharge. Bronchial stump syndrome was diagnosed by bronchoscopy when a communication between the left main bronchus and the ipsilateral thoracic cavity containing purulent material and a grey mass suggestive of an aspergilloma were seen. Computed tomography (Figure 1A and B) and microbiological studies confirmed the disease, with associated contralateral pneumonia probably secondary to aspiration. He was treated with intravenous amphotericin B without success. One month later, a left thoracotomy was
performed to resect the capsuled fungus ball which weighted 150 g and had a thickness of 2 cm (Figure 1C), followed by a window thoracostomy for continuous open wound care. The patient is being followed up in the Outpatient Clinic without complications and with a reduction of the window area, as expected. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest None declared.
Cardiothoracic Surgery Department, General Hospital of Mexico ‘‘Dr. Eduardo Liceaga’’, Mexico City, Mexico Corresponding author: Walid Leonardo Dajer-Fadel, MD, Ave. Cuauhte´moc #403, Edificio 12, Apartamento 102, Colonia Roma Sur, Delegacio´n Cuauhtemoc, CP 06760, Ciudad de Me´xico, Me´xico. Email: [email protected]
Downloaded from aan.sagepub.com at UCSF LIBRARY & CKM on March 11, 2015
Aspergilloma in a pneumonectomized cavity
Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(8) 991 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313495217 aan.sagepub.com
Walid Leonardo Dajer-Fadel, Rafael Borrego-Borrego and Rube´n Argu¨ero-Sa´nchez
Figure 1. (A) Coronal and (B) axial reconstructed computed tomography showing the fungus ball in the left apical pleural cavity. (C) The specimen after surgical resection.
A 59-year-old man with a history of left pneumonectomy due to congenital bullae nine years earlier, presented to our institution with cough of five months’ duration, associated with a purulent discharge. Bronchial stump syndrome was diagnosed by bronchoscopy when a communication between the left main bronchus and the ipsilateral thoracic cavity containing purulent material and a grey mass suggestive of an aspergilloma were seen. Computed tomography (Figure 1A and B) and microbiological studies confirmed the disease, with associated contralateral pneumonia probably secondary to aspiration. He was treated with intravenous amphotericin B without success. One month later, a left thoracotomy was
performed to resect the capsuled fungus ball which weighted 150 g and had a thickness of 2 cm (Figure 1C), followed by a window thoracostomy for continuous open wound care. The patient is being followed up in the Outpatient Clinic without complications and with a reduction of the window area, as expected. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest None declared.
Cardiothoracic Surgery Department, General Hospital of Mexico ‘‘Dr. Eduardo Liceaga’’, Mexico City, Mexico Corresponding author: Walid Leonardo Dajer-Fadel, MD, Ave. Cuauhte´moc #403, Edificio 12, Apartamento 102, Colonia Roma Sur, Delegacio´n Cuauhtemoc, CP 06760, Ciudad de Me´xico, Me´xico. Email: [email protected]
Downloaded from aan.sagepub.com at UCSF LIBRARY & CKM on March 11, 2015
