<![CDATA[Background: Aspergilloma is a colonization of a lung cavity by the fungus Aspergillus, which often occurs as a result of a prior tuberculous lesion. Thus, a multimodal approach is needed to be more effective at reducing recurrence and mortality. Case: A 45-year-old male smoker came with complaints of recurrent hemoptysis for one year, followed by shortness of breath. The patient was diagnosed with tuberculosis twice, both diagnoses confirmed bacteriologically and declared cured. The CT scan of the thorax with contrast concluded that the pulmonary tuberculosis was inactive, displaying a fungus ball at the apex of the left lung accompanied by multiple subpleural blebs. Lobectomy was performed to remove the fungus ball. The results of the biopsy showed pieces of aspergillosis fungal tissue with a fungus ball appearance accompanied by necrosis. Oral voriconazole was given as postoperative treatment for 7 days and continued with itraconazole for 6 months. The patient experienced clinical improvement and was able to return to activities during follow-up. Discussion: Lobectomy is often optimal despite its morbidity risks. The X-ray that reveals a residual space or hydropneumothorax also mandates prolonged water-seal drainage and strict observation according to protocol. Additionally, postoperative triazoles completely eradicated the disease. Conclusion: Surgery is a fairly effective treatment in cases of aspergilloma with recurrent hemoptysis. Surgical intervention allows for the complete removal of the fungal ball, its enclosing cavity, and the adjacent unhealthy lung tissue. Multidisciplinary and comprehensive treatment needs to be carried out to increase life expectancy and reduce the recurring symptoms.]]>
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