CTICasesMixed Infection (MAC and Aspergillomas)
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Imaging findings
Coronal and axial CT reformats show extensive bronchiectasis, bronchial plugging, and multiple airway-centric and cavitary nodules in both lungs. Within the upper lobe cavities, well-defined gravity-dependent filling defects are seen with associated intracavitary debris, characteristic of bilateral aspergillomas (fungal balls). Sputum cultures grew Mycobacterium avium complex (MAC), and histology confirmed aspergillosis.
Key takeaways
Patients with underlying lung disease, such as emphysema or bronchiectasis, who develop Mycobacterium avium complex (MAC) infection are prone to cavitary lung lesions. These pre-existing or MAC-induced cavities can subsequently become colonized by Aspergillus, leading to the formation of secondary aspergillomas (fungal balls) inside the cavities.
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