Pulmonary Fungus Research Articles

Sinus fungal balls caused by Syncephalastrum spp.: 2 clinical cases and literature review

IntroductionSyncephalastrum spp. is a mucoral that rarely produces pathology. Fungal balls caused by this genus are infrequent. It requires early diagnosis and treatment to avoid associated morbidity and mortality. MethodsWe describe two clinical cases of sinus fungus balls caused by Syncephalastrum spp. and review the literature. ResultsTwo patients were treated for sinus fungus balls. When their samples were analysed, the aetiology was determined to be Syncephalastrum spp. A case of pulmonary fungus ball due to Syncephalastrum spp. is described in the literature. All cases, including these described in the present study, had a good evolution after treatment. ConclusionsSyncephalastrum spp. is a filamentous fungus that should be considered as an aetiology of sinus fungus ball.

Antibiotic susceptibility pattern, risk factors, and prediction of carbapenem-resistant Pseudomonas aeruginosa in patients with nosocomial pneumonia

ObjectivesThis study was aimed at describing antibiotic susceptibility patterns and developing a predictive model by assessing risk factors for carbapenem-resistant Pseudomonas aeruginosa (CRPA). MethodsA retrospective case-control study was conducted at a teaching hospital in China from May 2019 to July 2021. Patients were divided into the carbapenem-susceptible P. aeruginosa (CSPA) group and the CRPA group. Medical records were reviewed to find an antibiotic susceptibility pattern. Multivariate analysis results were used to identify risk factors and build a predictive model. ResultsA total of 61 among 292 patients with nosocomial pneumonia were infected with CRPA. In the CSPA and CRPA groups, amikacin was identified as the most effective antibiotic, with susceptibility of 89.7%. The CRPA group showed considerably higher rates of resistance to the tested antibiotics. Based on the results of mCIM and eCIM, 28 (45.9%) of 61 isolates might be carbapenemase producers. Independent risk factors related to CRPA nosocomial pneumonia were craniocerebral injury, pulmonary fungus infection, prior use of carbapenems, prior use of cefoperazone-sulbactam, and time at risk (≥15 d). In the predictive model, a score >1 point indicated the best predictive ability. ConclusionsCRPA nosocomial pneumonia could be predicted by risk factor assessment particularly based on the underlying disease, antimicrobial exposure, and time at risk, which could help prevent nosocomial pneumonia.

UV Spectroscopy Analysis for Itraconazole

Itraconazole is a triazole antifungal agent that is synthesised. Itraconazole has been manufactured into a variety of pharmacological formulations and administered in a variety of ways. Itraconazole pills are used to treat pulmonary fungi that can cause fungal infection and spread throughout the body. Because Itraconazole is not yet officially listed in any pharmacopoeia, only a few procedures for quality control and stability testing in pharmaceutical formulations have been published. The goal of this study is to develop a more precise, easy, and cost-effective spectrophotometric approach for analysing Itraconazole in bulk and capsule dosage forms with improved precision, accuracy, and sensitivity. The UV spectroscopic determination was performed with Chloroform as the solvent at an absorption maximum of 267 nm. Linearity over the concentration range in the UV spectroscopic approach. The linearity of Itraconazole over the concentration range was found to be 1-10 g/ml using the UV spectroscopic technique, with a correlation coefficient of 0.999. The findings of the analyses were statistically and the recovery studies have confirmed this.

Saliva-controlled sputum culture (SSC) – A high value diagnostic tool for deep pulmonary infections

A major obstacle to prompt diagnosis of fungal pulmonary infections is that deep sputum samples are scarce, yet are frequently rejected if they contain saliva. We show that including saliva controls unfailingly distinguishes oropharyngeal flora from pulmonary fungi, thus preserving valuable samples for analysis, expediting diagnoses and improving patient care.

Pulmonary mycoses treated by topical amphotericin B

Since its discovery, amphotericin B (AmB) became a key management because it is the most common antifungal drug with activity to disrupt the fungal cell wall. Furthermore, it is the first-choice treatment in pulmonary mycoses that may consider lethal infection; the difference in lipid structure between fungal and mammalian cell membranes determines the effect of AmB. However, some fungal pulmonary diseases such as aspergillomas are partially contact with the blood and narrow touch the walls of the lung cavities, thus administration of systemic antifungal agents may be ineffective to eliminate these infections. Tissue penetration of systemic antifungal agents must be evaluated to get a proper appreciation of their antifungal activity, which may differ even within the same antifungal class. So, topical administration considered necessity in these situations. AmB belongs to the polyene group has a wide-spectrum in vitro and in vivo antifungal activity. All of the known available formulas of AmB are administrated through intravenous injection to treat severe systemic fungal infections, while the development of the topical formula of AmB is still under preliminary development, including topical pulmonary AmB. Due to the revealing of antimicrobial-resistant fungi in recent years and ineffective systemic management of pulmonary fungi, this study explains the role of topical AmB in treating refractory lung fungi that not response to other drugs that may help researchers to develop an effective topical formula of AmB regarding pulmonary mycosis.

Analysis of factors of pulmonary fungal infection in mice in respiratory medicine department based on logistic regression analysis model and Progranulin.

The objective of this research is to solve the current medical problems of a high incidence of fungal infections in the lungs, high misdiagnosis rate, and high mortality. In this study, firstly, the logistic regression model was used to conduct. Risk factors of pulmonary fungal infection in respiratory department were analyzed. Then a model of pulmonary fungal infection in mice was constructed, and the expression difference of Progranulin (PGRN) in serum was detected by enzyme-linked immuno sorbent assay (ELISA). The expression of PGRN in lung tissues of mice infected by pulmonary fungi was detected by Western bolt method and quantitative polymerase chain reaction (PCR). The PGRN protein and mRNA expression in the lung epithelial cells of mice were detected after the infection. Results logistic regression model was used to analyze the main risk factors affecting pulmonary infection in mice. The risk factors of pulmonary fungal infection were indent catheter, hypoproteinemia, long-term use of glucocorticoid and long-term use of antibiotics. The PGRN content in serum was obviously higher than that before pulmonary fungal infection (P < 0.01). The expression of PGRN mRNA and protein in lung tissue was obviously higher than that before infection (P < 0.01). The expression of PGRN mRNA and protein in lung tissues of the infected group was obviously higher than that of the non-infected group (P < 0.01). The expression of PGRN protein in the lung epithelial cells of mice was obviously higher at 24 h after infection than before infection (P < 0.01), and the expression of PGRN mRNA was obviously higher at 12 h after infection than before infection (P < 0.01), indicating that PGRN is highly expressed in fungal pulmonary infection and is involved in disease progression. Therefore, this study provides a new idea for the diagnosis and treatment of fungal pulmonary infection in the later stage and has a good guiding significance for the diagnosis and treatment of fungal pulmonary infection.

Surgical management of non-mycobacterial fungal infections.

Fungal infections of the lung are common in endemic areas and in immunocompromised patients. Antifungal therapy is the cornerstone of medical therapy for most pulmonary fungi but surgery is an important adjunct in cases of complicated disease or resistant organisms. A multidisciplinary approach including pulmonary medicine, infectious disease, interventional radiology, and thoracic surgery is favored. This article reviews the surgical management of common fungal pulmonary infections and their sequelae.

Comparison between molecular methods (PCR vs LAMP) to detect Candida albicans in bronchoalveolar lavage samples of suspected tuberculosis patients

With the increase of patients suffering from immune deficiency infections also increased pulmonary fungi even in people with defective immune system can cause fatal and lethal candidiasis. The timely diagnosis of pulmonary candidiasis is one of the problems that has been detected. Polymerase chain reaction (PCR) test and Loop mediated isothermal amplification (LAMP) method optimized on the basis of α INT1 gene and then sensitivity and specificity were evaluated. LAMP is a novel nucleic acid amplification technique with high specificity and sensitivity which has been done under isothermal condition. Samples were the bronchoalveolar lavage suspected of tuberculosis (TB) reviews for TB disease negative have been reported. DNA extraction carried out by standard phenol/chloroform method on samples and PCR test and LAMP was done. PCR and LAMP testing was performed on samples and products of 441 bp were amplified and observed with agarose gel electrophoresis. At the end of the LAMP reaction, SYBR Green was used for identifying negative and positive results. Among the 60 quantities sera, only 7 cases were PCR positive but 8 cases were LAMP positive. In comparison, between LAMP and PCR, the LAMP technique in spite of its simplicity, high sensitivity and specificity, could be an appropriate replacement for PCR.

Effects of Cinnamaldehyde on the Cell Wall of A. fumigatus and Its Application in Treating Mice with Invasive Pulmonary Aspergillosis.

Background The invasive pulmonary aspergillosis is a kind of high incidence of disease with difficulties in treatment, poor prognosis, and high mortality. Objectives The study aimed to reveal the effect of cinnamaldehyde on the fungal cell wall and verify its efficacy on invasive pulmonary aspergillosis on immunosuppressed Institute of Cancer Research mice (ICR mice). Methods ICR mice were given cyclophosphamide 200 mg.kg−1. d−1 by intraperitoneal injection for 2 days. On the 4th day, the mice were given 50 μL of Aspergillosis fumigatus spore (107colony form unit CFU/mL) by intranasal injection to establish immunosuppressive animal models with invasive Aspergillosis fumigatus infection. Then the mice in treatment group orally administered cinnamaldehyde for 14 consecutive days, while voriconazole was given to the mice in the positive control group. Results The clearance rate of pulmonary fungi, cure rate, and reduction of 1,3-β-D-glucans in treatment group were 80.00%, 80.00%, and 81.00%, respectively while in positive control group they were 67.00%, 60.00%, and 62.00%, respectively. There were significant differences in the results between two groups as mentioned above (P<0.05). Electron microscopy showed that, in treatment group, the cell wall of Aspergillus fumigatus was dissolved and detached and the cell surface was incomplete. There were edema, degeneration, and necrosis in nucleus and organelle, which lead to cellular necrocytosis. The cytomembrane of Aspergillus fumigatus was intact, clear, and complete, whereas the cytomembrane in the positive control group disappeared. The hyphal morphology of Aspergillus fumigatus was deformed, but the cell wall was intact. Conclusion Cinnamaldehyde has a good curative effect in the treatment of invasive pulmonary aspergillus infection in immunodeficient mice. It mainly affects the synthesis of 1,3-β-D-glucans from the cytoderm of Aspergillus fumigatus but does not affect cell wall. It would potentially be an effective and novel drug for targeted treatment of Aspergillus fumigatus deep infection.

Prevalence and profile of pulmonary fungal pathogens among HIV-infected patients attending University of Maiduguri Teaching Hospital, Nigeria

BackgroundFungal infections in lungs are being diagnosed with increasing frequency. This is related to the increased immunocompromised status and hygienic factors among patients. In view of this, the present study sought to isolate, identify, and determine the prevalence of pathogenic fungi in HIV-infected patients attending the University of Maiduguri Teaching Hospital, Nigeria.Materials and methodsBetween 5 April 2016 and 27 August 2016, three consecutive sputum samples in the early morning were collected from individual participants. The samples were inoculated onto Petri dishes containing sabouraud dextrose agar in triplicates for isolation. The fungal isolates were identified using standard mycological stains and reagents. Self-administered questionnaires and participants’ hospital cards were used to assess demographic and clinical variables, respectively.ResultsThe prevalence of pulmonary fungal infection among the patients was at 68%. Of the infected patients, male patients accounted for 59.8%, whereas female patients accounted for 40.1%. However, there was no significant association between the prevalence of pulmonary fungal infection and sex of subjects (P=0.630). Candida albicans [24 (23.5%)] accounted for the highest proportion of the fungal isolates, followed by Aspergillus spp. [19 (18.6%)], with the least being Torulopsis dattila [one (0.9%)], Torulopsis glabrata, [one (0.9%)], and Microsporum canis [one (0.9%)]. Subjects with ages between 31 and 35 years that the highest prevalence of pulmonary fungal infections, 28 (27.5%), whereas those between 56 and 60 years, had the least prevalence, 1 (20.0%). Among the 102 participants coinfected with HIV/tuberculosis (TB), 92 (90.2%) had fungal coinfections, representing a relatively higher prevalence compared with those without TB, 10 (20.8%). There was statistical association between the prevalence of pulmonary fungal infections and TB status and age of patients (P<0.05).ConclusionFindings from this study revealed a high prevalence of pulmonary fungi in HIV/TB coinfected patients, with C. albicans being the leading causal fungi responsible for symptoms of pulmonary diseases.

Clinical efficacy and safety of Qingyi Decoction administered by nasojejunal tube for the treatment of severe acute pancreatitis

Objective To compare the clinical efficacy and safety of Qingyi Decoction (a preparation of Chinese herbal medicine) between two different routes of the administration by using nasogastric tube or nasojejunal tube for treatment of severe acute pancreatitis (SAP). Methods A total of 79 SAP patients enrolled were randomly divided into nasogastric tube group (n=41) and nasojejunal tube group (n=38) according to the random number table method. In addition to the conventional therapy, they were treated with Qingyi Decoction administered by using nasogastric tube or nasojejunal tube. Results After treatment for 14 days, the levels of C-reactive protein (CRP), procalcitonin (PCT) and white blood cell count (WBC), urinary bladder pressure, and APACHE Ⅱ score in nasojejunal tube group were significantly lower than those in nasogastric tube group (P<0.05). The time required for the recovery of bowel sounds, length of abnormal serum amylase persistence, the duration of abdominal pain, the time necessary for mechanical respiratory support in nasojejunal tube group was significantly shorter than those in nasogastric tube group. The blood fungus infection rate and pulmonary fungus infection rate in nasojejunal tube group were significantly lower than those in nasogastric tube group, and 28-day survival rate in nasojejunal tube group was significantly higher than that in nasogastric tube group (P<0.05). Conclusion The nasojejunal tube route for the administration of Qingyi Decoction for the treatment of SAP can effectively alleviate the severity of patient’s condition, shorten the time required for improving clinical symptoms, reduce the incidence of morbidity and mortality, and it is worthy of further popularization in clinical practice. Key words: Severe acute pancreatitis; Nasojejunal tube; Nasogastric tube; Qingyi Decoction; Clinical curative effect

Scedosporium apiospermum: A Rare Case of Cavitary Lung Disease

Scedosporium apiospermum: A Rare Case of Cavitary Lung Disease

Clinicopathological and outcome analysis of adult lupus nephritis patients in China.

The objective of this study was to assess clinicopathological characteristics and outcomes of lupus nephritis adult patients in China. Clinicopathological features, treatment strategies, responses and outcome of 681 adult patients with biopsy-proved lupus nephritis were retrospectively analyzed. Six hundred and eighty-one LN patients were included and followed up for 52.5 ± 14.1 months. Differences in age, disease duration, BP, proteinuria, serum albumin, creatinine, ANCA-positive ratio and SLEDAI scores were noticed between male and female patients, indicating severer disease in male patients. LN IV patients were much severer in systemic damage as well as immunological changes. During follow-up, 354 patients achieved CR, 107 patients achieved PR, 95 patients progressed to ESRD and 36 patients died. Prognosis and treatment response of patients with different histological types differ apparently. Renal outcome of patients with LN II and III was benign, while LN IV, V and VI was poor. Cyclophosphamide was effective in most patients. MMF and CNI could be used as salvage treatment. In multivariate analysis, BP, sCr, hypocomplementemia, severe proliferative lesion (LN IV or VI) and SLEDAI score were recognized as independent indicators of poor renal outcome. Infections, especially pulmonary fungus infection, thrombotic microangiopathy are the most common causes of death in LN patients. Clinicopathological characteristics, treatment responses and long-term outcomes differ remarkably in LN patients with different gender and pathological subtypes. New indicators of poor renal outcome were identified. Infections and TTP were the most common causes of death in LN patients.

Clinical characteristics of primary pulmonary cryptococcosis in 28 patients

To determine the clinical characteristics, causes of pre-operative misdiagnosis and therapy of pulmonary cryptococcosis. We retrospectively analyzed the clinical data of 28 patients suffering from pulmonary cryptococcosis from 2008 to 2013 in the Second Xiangya Hospital of Central South University. All patients were diagnosed pathologically. Of the 28 patients, 19 had no clear host factors. No patient was exposed to pigeons recently. The imaging findings showed that most patients had solitary, multiple nodules, masses, and patches. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) showed abnormal accumulation of fluorodeoxyglucose. Seven patients demonstrated malignancy and 1 demonstrated tuberculosis. None was considered as pulmonary fungus diseases. Microscopically, cryptococcosis granuloma formation was found in all patients and cryptococcosis neoformans were detected by Periodic acid-schiff and Grocott methenamine silver staining methods in the histopathological examination, respectively. Twenty-seven patients underwent lobectomy, and 1 had the medical antifungal drugs treatment. During the follow-up, symptoms in only 1 patient were not controlled. Most pulmonary cryptococcosis patients have no evident immunocompromise. Clinical presentation of pulmonary cryptococcosis varies and is often related to the immune status of patients. Radiological manifestation of pulmonary cryptococcosis is indistinguishable from malignant tumor, and even 18F-FDG-PET imaging does not help to get a clear diagnosis. After surgical resection of the lung, systemic antifungal treatment is still necessary for special population. Systemic therapy of both fluconazole and itraconazole is classic choice for pulmonary cryptococcosis.

Pulmonary fungus ball caused by Penicillium capsulatum in a patient with type 2 diabetes: a case report

BackgroundFollowing the recent transfer of all accepted species of Penicillium subgenus Biverticillium to Talaromyces (including Talaromyces marneffei, formerly Penicillium marneffei), Penicillium species are becoming increasingly rare causal agents of invasive infections. Herein, we present a report of a type 2 diabetes patient with a fungus ball in the respiratory tract caused by Penicillium capsulatum.Case presentationA 56-year-old Chinese female gardener with a 5-year history of type 2 diabetes presented at the Shanghai Changzheng Hospital with fever, a cough producing yellow-white sputum, and fatigue. The therapeutic effect of cefoxitin was poor. An HIV test was negative, but the β-D-glucan test was positive (459.3 pg/ml). Chest radiography revealed a cavitary lesion in the left upper lobe, and a CT scan showed globate cavities with a radiopaque, gravity-dependent ball. The histopathologic features of the tissue after haematoxylin-eosin staining showed septate hyphae. The fungus was isolated from the gravity-dependent ball and identified as Penicillium capsulatum based on the morphological analysis of microscopic and macroscopic features and on ribosomal internal transcribed spacer sequencing. After surgery, the patient was cured with a sequential treatment of fluconazole 400 mg per day for 90 days and caspofungin 70 mg per day for 14 days.ConclusionsAlthough the prognosis is often satisfactory, clinicians, mycologists and epidemiologists should be aware of the possibility of infection by this uncommon fungal pathogen in diabetes patients, since it may cause severe invasive infections in immunocompromised hosts such as diabetes and AIDS patients.

The Ecology ofPneumocystis: Perspectives, Personal Recollections, and Future Research Opportunities

I am honored to receive the second Lifetime Achievement Award by International Workshops on Opportunistic Protists and to give this lecture. My research involves Pneumocystis, an opportunistic pulmonary fungus that is a major cause of pneumonia ("PcP") in the immunocompromised host. I decided to focus on Pneumocystis ecology here because it has not attracted much interest. Pneumocystis infection is acquired by inhalation, and the cyst stage appears to be the infective form. Several fungal lung infections, such as coccidiomycosis, are not communicable, but occur by inhaling <5μm spores from environmental sources (buildings, parks), and can be affected by environmental factors. PcP risk factors include environmental constituents (temperature, humidity, SO2 , CO) and outdoor activities (camping). Clusters of PcP have occurred, but no environmental source has been found. Pneumocystis is communicable and outbreaks of PcP, especially in renal transplant patients, are an ongoing problem. Recent evidence suggests that most viable Pneumocystis organisms detected in the air are confined to a patient's room. Further efforts are needed to define the risk of Pneumocystis transmission in health care facilities; to develop more robust preventive measures; and to characterize the effects of climatological and air pollutant factors on Pneumocystis transmission in animal models similar to those used for respiratory viruses.

Identification of Unique Volatile Compounds of Aspergillus fumigatus for Potential Diagnostic Breath Test by HS-SPME and GC-MS

Identification of Unique Volatile Compounds of Aspergillus fumigatus for Potential Diagnostic Breath Test by HS-SPME and GC-MS The 13/14C-urea breath test has been used in the diagnosis of gastric helicobacter pylori. The use of breath tests for diagnosis has been applied over the last 20 years. However, its applicability for diagnosis of pulmonary fungus infection was less studied. In this study, Aspergillus fumigatus-specific volatile compounds were qualitatively analyzed by headspace solid phase microextraction (HS-SPME) and gas chromatography/mass spectrometry (GC/MS).

Clinical analysis of fungus infection in acute exacerbation of chronic obstructive pulmonary disease

Objective To explore the risk factors and targeted therapy for fungus infection in acute exacerbation of chronic obstructive pulmonary disease (COPD) pulmonary.Methods 83 acute exacerbations of COPD patients with pulmonary fungus infection were selected as the observation object(COPD fungal infection group),according to the time sequence of random month by month in acute exacerbations of COPD no secondary fungal infection of the 80 patients hospitalized patients as control group,analysis of risk factors lead to fungal infection.Results Two groups in age,live ICU time,antibiotic use time,hormone use time,albumin level mechanical ventilation people with diabetes mellitus,merger,as cor pulmonale had statistically significant differences (P ＜ 0.05) ; The conditional Logistic multiariate analysis,age,ICU patients live time,antibiotics use time,hormone use time,albumin level was acute exacerbations of COPD factors such as pulmonary fungus infection independent risk factors(P ＜0.01) ;Fungus infection were combined with antimycotic,cured 69 cases (83.13％) improved 12 cases (14.46％),there was no change in 1 case(1.20％),death 1 case (1.20％).Conclusion Patients older age,live long,long time ICU antibiotics and hormones and the low level of albumin is acute exacerbations of COPD pulmonary fungus infection independent risk factors,timely diagnosis and prognosis of patients with antifungal treatment is good. Key words: Pulmonary disease, chronic obstructive; Lung diseases ,fungal; Risk factors

Hematopoietic Stem Cell Transplantation in a Very High Risk Group of Patients with the Support of Granulocyte Transfusion

High risk patients with active fungal infection who had undergone hematopoietic stem cell transplantation (HSCT) with the support of granulocyte transfusions (GTX) as an adjunct to antifungal agents are reviewed retrospectively. Patients requiring immediate allogeneic HSCT for their primary hematological disorders (two severe aplastic anemia, one T cell acute lymphoblastic leukemia (ALL) in second complete remission, one acute myeloid leukemia (AML)-in first complete remission, one T-ALL in refractory relapse) but were denied by other transplant programs due to active invasive fungal infections had undergone HSCT with the support of GTX at the stem cell transplantation unit of Gazi University. Five patients who had undergone six transplants were included in the study and received a total of 38 (3-13) granulocyte transfusions during these six transplants. The median granulocyte concentration was 3.4×10(11) per apheresis bag. Full clinical and radiological recovery was achieved in three of the five high risk patients with active invasive fungal infection with the combination of antifungal agents and GTX. Even a very high risk patient with aplastic anemia who had undergone two consecutive transplants due to secondary graft failure was also cured of his primary disease despite the presence of multiple pulmonary fungus balls. Three of the five patients with very high risk features due to the underlying hematological disease and the associated active fungal infection were rescued with allogeneic HSCT performed with the support of GTX combined with antifungal agents. Despite the limitations of this report due to its retrospective nature, it suggests that GTX might be an alternative in patients with active fungal infections who otherwise are denied by the transplant programs. However, prospective randomized studies are required to draw a solid conclusion regarding the role of GTX in HSCT recipients in desperate situations such as active fungal infections.

Pulmonary Aspergilloma Mimicking Metastasis from Papillary Thyroid Cancer

Whole-body scans (WBSs) based on diagnostic or therapeutic doses of I-131 can visualize metastatic lesions in thyroid cancer patients who have undergone total thyroidectomy. However, a variety of unusual lesions may cause false-positive results, and therefore, careful evaluation of abnormal scans is imperative to avoid unnecessary surgical removal or high-dose radioiodine treatment. Here, we report a patient with pulmonary aspergilloma mimicking metastasis of thyroid cancer on WBS. A 53-year-old woman with papillary thyroid cancer stage III (T1N1aM0) who had undergone total thyroidectomy and 150 mCi of radioiodine treatment for remnant ablation was found to have focal intense radioiodine accumulation in the left lung field by WBS, suggestive of pulmonary metastasis, at 5 days after I-131 administration. Whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and Tc-99m methoxyisobutyl isonitrile scans showed no remarkable tracer accumulation at the pulmonary nodule. An enhanced chest CT scan demonstrated a nonenhancing pulmonary nodule with an air-crescent sign suggestive of pulmonary fungus ball. A subsequent blood test for precipitating antibodies to Aspergillus antigens produced a result of 29.9 U/mL (reference range: 0-8 U/mL). The patient was clinically diagnosed as having pulmonary aspergilloma based on serologic test and radiologic imaging results. Extreme caution should be exercised when interpreting abnormal radioiodine WBS findings when the serum thyroglobulin is normal and imaging characteristics indicate a benign condition. Pulmonary aspergilloma is a cause of a false-positive lesion when radioiodine WBSs are performed.