Rapid occurrence of pulmonary aspergillosis after pulmonary wedge resection

A 61-year-old man with diabetes mellitus undertook wedge resection of pulmonary tuberculoma in the left upper lobe. He was discharged uneventfully. However, he became febrile with productive cough five weeks after the discharge, and was readmitted. Imaging studies showed a cavitary lesion at the formerly resected site and multiple infiltrates in the other lobes. A diagnosis was rapidly deteriorating pulmonary aspergillosis. While medical treatments helped his general condition to improve, pulmonary shadows remained unchanged. Finally, we successfully treated him firstly, by performing left upper lobectomy and secondly, by treating multiple infiltrates with postoperative medical treatments. Multiple infiltrates improved gradually and diminished one month after surgery. He remains well without relapse for ten years after surgery.