Fungus Ball, A Hemoptysis Cause In An SLE Patient

This case report discusses a 48-year-old man with systemic lupus erythematosus (SLE) and antiphospholipid syndrome who developed a fungus ball (aspergilloma) in a pulmonary cavity, 15 years after being treated for disseminated tuberculosis. The patient experienced recurring hemoptysis, and imaging revealed a mobile mass in the left upper lobe, confirmed as Aspergillus flavus. The report highlights that aspergillomas often develop silently and can be challenging to detect without CT scans, which show distinctive signs like the Monod and air crescent signs. Surgical resection is the preferred treatment, with antifungal therapy recommended for high-risk patients. The case underscores the increased risk of aspergilloma in SLE patients due to impaired immunity from glucocorticoid and immunosuppressive treatments.