For fungal infections of the lung, when is surgical intervention considered?

• A. To obtain biopsy for treatment planning or when cancer is suspected
• B. As first-line therapy for all fungal infections
• C. Only for aspergilloma without symptoms
• D. Never, always medical therapy

Answer: (A)

In fungal lung infections, surgery is not a routine cure but a diagnostic and selective therapeutic option. The key reason to operate is to obtain a tissue sample that provides a definitive diagnosis and helps plan treatment, especially when imaging or clinical features make cancer a strong concern. Lung tissue obtained via biopsy or resection allows histopathology to distinguish fungal infection from malignancy and to tailor antifungal therapy or oncologic management accordingly. While surgery can be helpful for localized disease or to remove a lesion in certain situations, it is not the initial approach for all fungal infections. Other choices aren’t correct because antifungal medications are typically the first-line treatment, and surgery is not indicated for an asymptomatic aspergilloma or deemed never necessary.