Mycology: aspergilloma: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Microbiology · Mycology: aspergilloma

Sample item

A 55-year-old man treated for cavitary tuberculosis years ago has recurrent haemoptysis. Chest imaging shows a mobile rounded mass within an upper-lobe cavity with a crescent of air above it. Which laboratory finding best supports the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Strongly positive serum Aspergillus IgG precipitins

A fungus ball (aspergilloma) develops when Aspergillus colonises a pre-existing cavity, commonly from old tuberculosis, and forms a mass of hyphae. The imaging shows the air-crescent sign, and serum Aspergillus IgG precipitins are almost always positive. Haemoptysis is the main complication, and severe bleeding is managed by embolisation or surgery.

Option by option

  • A. Positive India ink preparation of sputum

    India ink demonstrates the capsule of Cryptococcus, which is not a cause of a fungus ball.

  • B. Strongly positive serum Aspergillus IgG precipitins (correct)

    Strongly positive Aspergillus IgG precipitins fit a fungus ball in an old cavity.

  • C. Markedly raised total IgE with eosinophilia

    Very high total IgE with eosinophilia suggests allergic bronchopulmonary aspergillosis.

  • D. A positive CBNAAT with rifampicin resistance

    Active tuberculosis is not suggested by a mobile mass with an air crescent.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Strongly positive serum Aspergillus IgG precipitins. A fungus ball (aspergilloma) develops when Aspergillus colonises a pre-existing cavity, commonly from old tuberculosis, and forms a mass of hyphae.

Why is "Positive India ink preparation of sputum" not the answer?

India ink demonstrates the capsule of Cryptococcus, which is not a cause of a fungus ball.

Why is "Markedly raised total IgE with eosinophilia" not the answer?

Very high total IgE with eosinophilia suggests allergic bronchopulmonary aspergillosis.

Why is "A positive CBNAAT with rifampicin resistance" not the answer?

Active tuberculosis is not suggested by a mobile mass with an air crescent.

What concept does this question test?

It tests Mycology: aspergilloma in Microbiology. The imaging shows the air-crescent sign, and serum Aspergillus IgG precipitins are almost always positive. Haemoptysis is the main complication, and severe bleeding is managed by embolisation or surgery.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mycology: aspergilloma?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.