The effective management of invasive aspergillosis includes strategies to optimize prevention, prompt diagnosis, early antifungal treatment, and, in some cases, immunomodulation and surgery. Treatment of aspergilloma is considered when patients become symptomatic, usually with hemoptysis Surgical resection is curative but may not be possible in patients with limited pulmonary. Surgery is currently the mainstay of treatment for aspergilloma but is associated with considerable mortality and morbidity Alternative options exist for patients who are poor surgical candidates and for those who prefer a less invasive treatment modality. The management of pulmonary aspergillosis is complicated by the limited number of treatment options, drug interactions, adverse events and the emergence of antifungal resistance.
Aspergilloma treatment typically involves surgical resection for symptomatic cases, particularly when patients experience hemoptysis, or antifungal medications such as voriconazole or itraconazole for patients who are poor surgical candidates. Treatment may be a combination of surgery and antifungal medications People with severe cases may need surgery Immunosuppressive medications should be discontinued or decreased, if possible. Surgery is curative but not always an option—due to risk, cost, or lung function Fungal ball regrowth can occur, even after surgery, especially if cavities remain and exposure to spores continues.
In some cases, surgery may be suggested.
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