Bronchial stump aspergillosis (BSA) is a rare form of pulmonary aspergillosis with infection along the sutures closing the bronchus where a lung has been resected.
Clinical features:
(1) history of lobectomy with closure of the bronchus with sutures
(2) exposure of suture material to the bronchial lumen, especially silk
(3) development of hemoptysis, purulent sputum, and/or cough months or years after the surgery
(4) presence of an aspergilloma at the bronchial stump
Many of the affected patients had the lobectomy for lung cancer, so recurrent cancer is often in the differential diagnosis.
If the infection is severe there may be a breakdown of the stump, resulting in pleural aspergillosis with or without empyema.
Removal of the suture material by laser or bronchoscopy may be sufficient to prevent recurrence. Therapy with oral itraconazole is often effective.
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