Hemoptysis in a patient with pulmonary aspergilloma and type 2 diabetes mellitus: A rare case in an Indonesian adult

Int J Surg Case Rep. 2021 Jul:84:106125. doi: 10.1016/j.ijscr.2021.106125. Epub 2021 Jun 18.

Abstract

Background: The success rate of surgery on aspergilloma is quite low since aspergilloma generally spreads throughout the lung cavity.

Case presentation: A 45-year-old woman with a past history of type 2 diabetes mellitus presented with chronic hemoptysis. Clinical presentation and work up revealed a left lung aspergilloma, with x-ray and CT-scan showing a mass in the upper lobe of left lung and FNAB showing Aspergillus sp. The patient underwent thoracotomy with left superior lobectomy. Histopathological examination of specimens showed hyphae with septa. The patient had postoperatively controlled pleural effusions.

Discussion: T2DM is a risk factor for Aspergillus sp infection because it is immunocompromised when hyperglycemia occurs. Pulmonary aspergilloma has a poor prognosis during surgery. Removing aspergilloma in the lung cavity and maintaining blood glucose levels can provide a good prognosis. Keeping the amount of fluid from increasing is the main focus of post-surgery.

Conclusion: Pulmonary aspergilloma that only occurs in one lung lobe has a good prognosis after surgery.

Keywords: Hemoptysis; Lobectomy; Pulmonary aspergiloma; Type 2 diabetes mellitus.