Surgery for pulmonary mycosis

We reviewed 739 cases of surgery for pulmonary infection between 1970 and 1990 at the Persahabatan Hospital, Jakarta. In 32 cases (13.61%) surgery was performed for pulmonary mycosis. There were 20 males and 12 females; the majority were between 31 and 50 years of age and all were symptomatic. Primary mycosis infection was found in only 1 case (3%) with a diagnosis of coccidioidomycosis; the other 31 patients had aspergillosis secondary to tuberculosis. Pneumonectomy was performed in 2 cases (6%), lobectomy in 28 cases (88%), and cavernoplasty in 2 cases (6%). Four operations were performed on an emergency basis, 15 were regarded as semi-emergencies, and 13 were carried out electively. Postoperative complications consisted of 2 cases of bronchopleural fistula, one of which was self-healing and the other needed a muscle plombage. There was 1 death (mortality 3%) from septic shock 3 weeks after the operation. The low mortality and morbidity support a surgical approach to the treatment of pulmonary mycosis in symptomatic patients.