Furthermore, as with aspergilloma, there must be positive IgG testing but this can be with or without culture. To confirm Aspergillus nodules as opposed to aspergilloma, these must be seen directly on imaging or confirmed by percutaneous or surgical biopsy.The fibrosing form—chronic fibrosing pulmonary aspergillosis—has similar criteria to chronic cavitary pulmonary aspergillosis but will be accompanied by significant fibrosis seen on either biopsy, tomosynthesis, or high resolution computed tomography.If chronic pulmonary aspergillosis has progressed to subacute invasive pulmonary aspergillosis, there must be a degree of immunosuppression. The microbiological criteria are similar to those of invasive aspergillosis but normally slower in progression, i.e. months rather than weeks. Furthermore, there must be evidence of IgG or galactomannan in the blood and a confirmatory biopsy of affected tissue. Treatment
People with single aspergillomas generally do well with surgery to remove the aspergilloma, and are best given pre-and post-operative antifungal medications. Often, no treatment is necessary; however, if a person coughs up blood (haemoptysis), treatment may be required using surgery or injection of dye to locate the bleeding combined with embolisation using chemicals or tiny material meant to block the bleeding blood vessel. Studies of tranexamic acid for treating haemoptysis do not provide strong evidence for long-term benefit.For chronic cavitary pulmonary aspergillosis and chronic fibrosing pulmonary aspergillosis, lifelong use of antifungal medications is commonplace. Itraconazole and voriconazole are first- and second-line antifungal agents respectively.
Fetus in fetu (or foetus in foetu) is a rare developmental abnormality in which a mass of tissue resembling a fetus forms inside the body of its twin. An early example of the phenomenon was described in 1808 by George William Young.There are two hypotheses for the origin of a "fetus in fetu". One hypothesis is that the mass begins as a normal fetus but becomes enveloped inside its twin. The other hypothesis is that the mass is a highly developed teratoma. "Fetus in fetu" is estimated to occur in 1 in 500,000 live births. Classification as life
A fetus in fetu can be considered alive, but only in the sense that its component tissues have not yet died or been eliminated. Thus, the life of a fetus in fetu is akin to that of a tumor in that its cells remain viable by way of normal metabolic activity. However, without the gestational conditions in utero with the amnion and placenta, a fetus in fetu can develop into, at best, an especially well differentiated teratoma; or, at worst, a high-grade metastatic teratocarcinoma. In terms of physical maturation, its organs have a working blood supply from the host, but all cases of fetus in fetu present critical defects, such as no functional brain, heart, lungs, gastrointestinal tract, or urinary tract. Accordingly, while a fetus in fetu can share select morphological features with a normal fetus, it has no prospect of any life outside of the host twin.