Radiology Case Reports (Apr 2022)

Co-existing active pulmonary tuberculosis with aspergilloma in a diabetic patient: A rare case report

  • Widiastuti Soewondo, MD,
  • Candra Sari Kusumaningrum, MD,
  • Muchtar Hanafi, MD, MSc,
  • Artrien Adiputri, MD, MBiomed,
  • Prima Kharisma Hayuningrat, MD

Journal volume & issue
Vol. 17, no. 4
pp. 1136 – 1142

Abstract

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Pulmonary aspergilloma is commonly associated with tuberculosis. Pulmonary aspergilloma is found in residual tuberculosis cavities and potential for other pathogens’ infections due to its sufficient oxygen and necrotizing tissue. A 48-year-old woman came with shortness of breath and cough for 7 months. She was diagnosed with pulmonary tuberculosis 9 months ago and was still under anti-tuberculosis drug therapy. She also suffered from type II diabetes mellitus. Chest examination showed vesicular sound decreased in third to fourth left intercostal spaces. A chest x-ray revealed a thick-walled cavity with the air-crescent sign in the left upper lobe lung leads to aspergilloma and active pulmonary tuberculosis. This finding was confirmed by the contrast-enhanced CT scan of the chest and continued to lobectomy. Histological examination confirmed the presence of a granuloma formation, necrosis, hyphae structure with the conclusion of Aspergillus sp. infection.

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