Abstract
The development of an aspergilloma in a damaged lung is often a silent process, though such patients are more likely to have chronic cough and recurrent haemoptysis. Two patients are described who had aspergillomas associated with chronic ill health, weight loss, and copious purulent and often bloodstained sputum. Treatment with antibiotics was ineffective but the response to corticosteroids was striking. Reasons are given for believing that the symptoms were due to an Arthus type of antigen-antibody reaction in the cavity wall.