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Clinical Image
A Case of Vanishing Pulmonary Aspergilloma
Un caso de desaparición del aspergiloma pulmonar
Luis Gorospea,
Corresponding author
luisgorospe@yahoo.com

Corresponding author.
, Ana María Ayala-Carboneroa,b, Jesús Fortúnc
a Department of Radiology, Ramón y Cajal University Hospital, Madrid, Spain
b Department of Pathology, Ramón y Cajal University Hospital, Madrid, Spain
c Department of Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain
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    "titulo" => "A Case of Vanishing Pulmonary Aspergilloma"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest radiograph &#40;A&#41; and CT &#40;B&#41; show a destructive pattern of the right lung and a stable&#44; previously documented&#44; aspergilloma &#40;asterisk&#41; within a dominant right upper lobe cavity &#40;arrow&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 70-year-old ex-smoker man presented with low-grade fever and progressive dyspnea&#46; His past medical history was significant for chronic obstructive pulmonary disease&#44; combined pulmonary fibrosis and emphysema syndrome&#44; and chronic pulmonary aspergillosis &#40;CPA&#41; secondary to previous tuberculosis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A chest radiograph showed a stable destructive pattern of the right lung but disappearance of a previously documented aspergilloma within a right upper lobe cavity &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#46; A contrast-enhanced thoracic computed tomography &#40;CT&#41; confirmed the vanishing of the aspergilloma but also demonstrated the appearance of a new pleural effusion and an enhancing thickened pleural surface of the right hemithorax &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; A thoracentesis confirmed a fungal empyema&#44; and a chest &#8220;pig-tail&#8221; catheter was inserted &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#46; The patient was started on voriconazole &#40;200<span class="elsevierStyleHsp" style=""></span>mg twice daily&#41; and has shown&#44; six months later&#44; an excellent response with resolution of his symptoms and of the pleural effusion&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">CPA is an uncommon but problematic pulmonary disease most commonly complicating previous tuberculosis infections&#46; The most common forms of CPA are chronic cavitary pulmonary aspergillosis and aspergilloma&#46; Chest radiographs and CT remain the most important imaging modalities for the suspicion and diagnosis of CPA&#46; Spontaneous vanishing of a pulmonary aspergilloma is an extremely rare phenomenon with only three previous described case reports in the literature&#46; Disappearance of a previously documented aspergilloma on imaging should prompt physicians to suspect a spontaneous perforation of the pleura and appearance of a fungal empyema&#44; especially in patients with CPA&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Author&#39;s contribution</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors have made substantial contributions regarding not only the conception and design of the manuscript&#44; but also the drafting and critical revision of the article&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest and Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">None of declare&#46;</p></span></span>"
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Article information
ISSN: 15792129
Original language: English
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