Thinking beyond Tuberculosis: A Case Report

Aspergilloma describes the saprophytic colonization of an area of devitalized lung tissue. It usually develops in pre-existing pulmonary cavities caused by tuberculosis, sarcoidosis and other such conditions. It is found in almost 15% to 25% of patients with cavitatory lesions resulting from tuberculosis. In developing countries with high prevalence of tuberculosis, like India, aspergilloma is often misdiagnosed as tuberculosis. Hemoptysis is often equated with TB, and most patients are diagnosed clinically. Here we report one such case of a 56 year old male patient with past history of tuberculosis, who was initially diagnosed and being treated as a relapse of tuberculosis on the basis of hemoptysis and chest radiograph findings, till further detailed investigations revealed an aspergilloma in a post tubercular cavity as the cause of his symptoms.