Gadayan Pulmonary Clinic

23/08/2026

The color of a pleural fluid can say something about the root cause of fluid build-up in pleural space. Clear or straw-yellow fluid usually points to systemic issues like heart or liver disease, while cloudy fluid indicates inflammation or infection. Milky white fluid signifies a lymphatic leak, red or bloody fluid suggests trauma or cancer, and thick pus reveals a severe bacterial infection. Rarer colors like brown or green can point to liver abscesses or bile leaks.

22/06/2026

An Aspergilloma, commonly called a "fungus ball," is a non-invasive clump of Aspergillus mold that develops inside pre-existing lung cavities or air spaces. It primarily affects individuals with underlying lung conditions such as Tuberculosis.
Because these fungal balls lack a direct blood supply, standard systemic medications often struggle to pe*****te them effectively. And concomitant treatment with Tuberculosis can add to the challenge.

This is the case of a 45/M newly-diagnosed diabetic, PTB Bacteriologically-confirmed, with concomitant Aspergilloma. He is symptomatic with recurrent hemoptysis. A Chest CTscan revealed cavitary TB and confirmed presence of an Aspergilloma. Despite financial constraints and limited access to advance diagnostics, he has shown great commitment to his treatment. After just 1 month of TB and Azole treatment, the cavitation and the Aspergilloma has shown significant reduction size (although, the significant reduction in the cavity size is primarily a response to anti-tuberculosis therapy).

This case exemplifies the dangerous clinical triad of Diabetes, Pulmonary Tuberculosis and Aspergilloma. Each condition fuels the other in a vicious cycle of immune suppression, tissue destruction, and treatment complications. It also puts into focus the limitations and socio-economic disparity in the Philippine healthcare.��

Hoping for the best for this patient.

16/06/2026