Chronic necrotizing pulmonary aspergillosis. A report of 9 cases with analysis of clinical picture, risk factors and treatment for outcome correlation

Monaldi Arch Chest Dis. 2001 Jun;56(3):202-7.

Abstract

Nine patients with chronic necrotizing pulmonary aspergillosis (CNPA) were analyzed retrospectively. Eight cases had been treated with itraconazole. Four patients had received intravenous amphotericin B (AMB), three sequentially with itraconazole and one as monotherapy. Three patients died after 1, 2 and 24 weeks of therapy. Six responded to therapy and survived 3 to 58 months after treatment. Only the total number of risk factors was found to be statistically significant in relation to a fatal outcome. The mean number of risk factors was 5.33 for fatal cases compared to 2.83 for treatment responders. The presence of five or more risk factors and two individual risk factors, hypoalbuminemia less than 27 g/L and history of dual pulmonary mycobacterioses, were 100% predictive of mortality in our patients. The overall clinical picture of fatal CNPA cases resembles closely that of acute invasive pulmonary aspergillosis in severely immunocompromised subjects.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Antifungal Agents / administration & dosage*
  • Aspergillosis / drug therapy*
  • Aspergillosis / mortality
  • Aspergillosis / pathology*
  • Biopsy, Needle
  • Chronic Disease
  • Follow-Up Studies
  • Hong Kong / epidemiology
  • Humans
  • Infusions, Intravenous
  • Lung Diseases, Fungal / drug therapy*
  • Lung Diseases, Fungal / mortality
  • Lung Diseases, Fungal / pathology*
  • Male
  • Middle Aged
  • Necrosis
  • Registries
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents