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If that's the case, the borderline amongst saprophytic fungal infection of bronchial anastomosis and local, invasive Aspergillus tracheobronchitis in lung or heart and lung transplant recipients may be quite elusive (see even more: Aspergillus tracheobronchitis in patients immediately after lung transplantation).Aspergillus development on silk sutures closing a bronchial stump is an additional illustration of saprophytic fungal-host partnership. This infection ordinarily develops 6�C12 months after lung resection and might spread to mucous plug or debris as well as granulation tissue situated in the stump. The removal in the thread solves the situation, and generally no antifungal treatment is critical . A considerably longer latency time period between lung resection and improvement of bronchial stump aspergillosis, ranging involving four and seven years, was also reported [32, 33]. Noppen et al. found that, albeit bronchoscopic elimination with the silk thread appears for being the 1st preference treatment, therapy with oral itraconazole also can end result in resolution of infection . Le Rochais et al. demonstrated that bronchial stump aspergillosis is just not distinct for silk thread but can also affect individuals in whom nylon threads have been utilized .Since invasion of bronchial mucosa was reported in individuals with bronchial stump aspergillosis , that is nevertheless yet another illustration that the line between saprophytic and invasive Aspergillus infection might not be effectively defined, and borderline circumstances is usually expected in clinical practice.Aspergillus can overgrow necrotic debris and mucous plug within the surface of endobronchial tumors. We observed a thick layer of Aspergillus hyphae covering an endobronchial carcinoid tumor (information not published).