Thank you for asking your question at Doctorspring.com
Sorry to know about your condition. I will try to help you in the best ways possible. I have gone through your medical history, Investigation reports, biopsy reports and the 2 CT scan films you have uploaded.
The diagnosis of aspergillosis is never an easy one. Partially because there is no one sure shot test which can say it is there or not. But in your case after reviewing all the investigation reports and your clinical history, a diagnosis of Pulmonary Apergilloma is the most probable one. The X-ray and CT images you provided show some characteristic findings of the disease. In addition to that the culture, PCR and galactomannan antigen detection is also positive. An international consensus panel has recommended that a diagnosis of probable invasive fungal infection in patients with risk factors (eg, cancer patients and hematopoietic stem cell transplant recipients) can be made without a culture yielding Aspergillus if there are clinical findings suggestive of aspergillosis along with either microscopic evidence of septate hyphae on examination of bronchoalveolar lavage fluid or sputum or a positive serum galactomannan or beta-D-glucan assay.
Aspergillosis is a common fungi found in plenty in the environment. Normally It’s harmless. But once you have some defect in your immunity you become more susceptible for infection with the fungi. You are having a form of Apsergillosis called Aspergilloma. In this form of apsergillosis the fungi forms like a ball in a cavity in the lungs. Normal lungs do not have any cavities. Since you had Tb previously it might have caused a cavity in the lungs.
Regarding the treatment options, I strongly recommend surgical treatment followed up by medical options like antifungal. Meanwhile any immunity suppressing conditions should be treated.
Please find the detailed reports attached.
Report - pdf
Report - .docx - MS word file