“ Affects patients with normal immunity but abnormal lungs. Fungal infection occurs within a pre-existing cyst, cavity, bulla or area of bro...
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Affects patients with normal immunity but abnormal lungs. Fungal infection occurs within a pre-existing cyst, cavity, bulla or area of bronchiectasis. Commonly referred to as mycetoma.
Plain film
• Typically upper lobe abnormality, mass within a cavity frequently accompanied by pleural thickening.
• ‘Monad’/air crescent sign—the fungus ball is frequently surrounded by a crescent of air.
CT
• Fungus ball (may calcify) lying dependently within a cavity or thin-walled cyst.
Intervention
• Bronchial arteries supplying the abnormal lung become hypertrophied and are liable to bleed.
• Bronchial artery embolisation may be performed for haemoptysis.
• Haemoptysis is the most important complication
Cystic fibrosis with aspergilloma. Chest x-ray demonstrating a right upper zone cavity with a soft tissue focus outlined by a crescent of air (Monad sign; white arrow) in keeping with an aspergilloma. A further aspergilloma is identified within the left mid-zone (red arrow).
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