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Rare lung & airway condition

Aspergilloma and chronic pulmonary aspergillosis

Chronic pulmonary aspergillosis (CPA) is a slow fungal infection of damaged lung - often forming a fungal ball (aspergilloma) in an old cavity - causing weight loss, cough and sometimes serious bleeding.

Key points

The essentials at a glance.

What to look out for, how the diagnosis is confirmed, who looks after it, and the options that exist.

  • 01

    It develops in lungs scarred by TB, sarcoidosis, COPD bullae or previous surgery - not in healthy lungs.

  • 02

    Symptoms are indolent: months of fatigue, weight loss, productive cough and haemoptysis.

  • 03

    Diagnosis combines CT (cavities, fungal ball, pleural thickening) with Aspergillus IgG blood testing.

  • 04

    Coughing blood is the most dangerous complication - massive haemoptysis is an emergency.

  • 05

    Treatment is long-term azole antifungals with therapeutic drug monitoring; surgery or embolisation for selected cases. The UK National Aspergillosis Centre in Manchester specialises in complex disease.

Understanding it

What it is, and what happens next.

In plain English - what is going on, how specialists confirm it, and the routes to treatment in the UK.

Where lung architecture has been destroyed, Aspergillus can settle and grind away at the walls of cavities for years - sometimes as a discrete ball of fungus rolling inside an old TB cavity, sometimes as a creeping, fibrosing infection. The systemic toll of chronic infection and the erosion of blood vessels in cavity walls are what give the disease its weight.

Management belongs with respiratory teams experienced in fungal disease: azole therapy is prolonged and needs drug-level and interaction monitoring, haemoptysis is triaged urgently with embolisation available, surgery cures selected single aspergillomas in fit patients, and complex or azole-resistant disease can be referred to the national centre. In many parts of the UK, routine NHS outpatient referrals for problems like this can take several months, whereas an initial appointment with a private consultant is typically available within around two weeks.

A quiet reminder

This guide is for information, not medical advice.

Your GP or specialist knows your history and can tell you which parts apply to you. If in doubt, speak to them.

Published 2026-09-27 · Next review 2027-09-27

Frequently asked

Common questions about Aspergilloma and chronic pulmonary aspergillosis.

Quick, plain-English answers to what people ask us most.

  • What is aspergilloma and chronic pulmonary aspergillosis?

    Aspergilloma and chronic pulmonary aspergillosis is a recognised medical condition that can affect people in different ways, ranging from mild and easily managed to more significant, depending on the underlying cause, how early it is picked up, and how it is treated. Getting a clear diagnosis is usually the first step towards the right management plan.

  • What causes aspergilloma and chronic pulmonary aspergillosis?

    Aspergilloma and chronic pulmonary aspergillosis can arise from a combination of factors, which may include genetics, lifestyle, environmental exposures, other underlying health conditions, or simply the normal effects of ageing on the body. In many cases no single cause is found, and several factors act together. A clinician can help identify which factors are most relevant in an individual case.

  • What are the symptoms of aspergilloma and chronic pulmonary aspergillosis?

    Symptoms of aspergilloma and chronic pulmonary aspergillosis vary from person to person and depend on how severe the condition is and which structures are affected. Some people notice symptoms gradually over weeks or months, while others experience a more sudden onset. Because symptoms can overlap with other conditions, a proper assessment is important to reach an accurate diagnosis rather than relying on symptoms alone.

  • Is aspergilloma and chronic pulmonary aspergillosis serious or dangerous?

    Most cases of aspergilloma and chronic pulmonary aspergillosis are manageable, especially when identified and treated early, but severity varies from mild and self-limiting to more significant, depending on individual circumstances. Left unassessed, some cases can lead to complications or a longer-term impact on daily life. If you are worried about your symptoms, it is always worth getting them checked rather than waiting.

  • Is aspergilloma and chronic pulmonary aspergillosis hereditary or genetic?

    Some cases of aspergilloma and chronic pulmonary aspergillosis have a genetic component and can run in families, while others occur without any family history at all. Having a relative with the condition may modestly increase your own risk, but it does not mean you will definitely develop it yourself. If you are concerned about a family history, mention this to your doctor, as it may occasionally influence screening or monitoring.

  • Can aspergilloma and chronic pulmonary aspergillosis be cured, reversed or prevented?

    Outlook varies with aspergilloma and chronic pulmonary aspergillosis: some cases resolve completely with treatment, others improve significantly but need ongoing management, and a smaller number become a long-term condition to be controlled rather than cured. Prevention strategies, such as addressing modifiable risk factors, can reduce your chances of developing it or of it recurring, but cannot guarantee against it in every case.

  • How is aspergilloma and chronic pulmonary aspergillosis treated?

    Treatment for aspergilloma and chronic pulmonary aspergillosis is tailored to the individual and depends on severity, underlying cause and personal circumstances. Options can range from simple lifestyle measures, monitoring and conservative treatment through to medication, specialist procedures or surgery in more significant cases. A specialist assessment helps identify which combination of treatments is most appropriate for you.

  • How long does aspergilloma and chronic pulmonary aspergillosis last?

    The duration of aspergilloma and chronic pulmonary aspergillosis varies considerably: some people recover within days or weeks, while others live with a more persistent or recurring condition that needs ongoing management. Response to treatment, how early it is started, and individual factors all influence the timescale. Your clinician can give you a more personalised estimate once your specific circumstances are known.

  • When is surgery needed for aspergilloma and chronic pulmonary aspergillosis?

    Surgery is not usually the first option for aspergilloma and chronic pulmonary aspergillosis and is generally reserved for cases where conservative treatment has not worked, symptoms are severe, or there is a significant structural problem that needs to be corrected directly. The decision depends on your specific findings, symptoms and how they are affecting your life. A specialist consultation is the best way to establish whether surgery is being considered too early, or should be considered sooner rather than later.

  • When should I see a doctor about aspergilloma and chronic pulmonary aspergillosis, and how quickly can I be seen privately?

    It is worth seeing a doctor about aspergilloma and chronic pulmonary aspergillosis if symptoms are persistent, getting worse, or affecting your daily life, rather than waiting to see if they settle on their own. NHS routine referrals to a specialist can currently take anywhere from around 20 to 45 weeks or more depending on your area, whereas a private consultant can typically see you within about 2 weeks. Getting an earlier assessment can help clarify the diagnosis and start the right treatment sooner.