| Clinical characteristics and treatment outcomes of chronic necrotizing pulmonary aspergillosis: a review of 43 cases. | |
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MedLine Citation:
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PMID: 19910234 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Chronic necrotizing pulmonary aspergillosis (CNPA) is uncommon, and the optimal therapeutic regimen has not been established. In a retrospective cohort study, we investigated the clinical characteristics and treatment outcomes of patients with CNPA. METHODS: We reviewed the medical records of all patients who had been diagnosed with CNPA at our institution over the last 10 years. RESULTS: Forty-three patients were identified. Their median age was 60 years (interquartile range (IQR) 45-65 years), and 34 (79%) of the patients were men. The most common underlying lung disease was pulmonary tuberculosis (n=40, 93%). After CNPA was diagnosed, all patients were treated with antifungal drugs, including oral itraconazole (n=39, 91%) or intravenous amphotericin B (n=4, 9%). Seventeen (40%) patients discontinued therapy early (<3 months), 14 patients due to death and three to loss of follow-up. Twenty-six (60%) patients received oral itraconazole at a daily dose of 200-400mg for more than 3 months. The median treatment duration was 6 months (IQR 6-12 months). In these 26 patients, clinical improvement was observed in 15 (58%) and radiological improvement was observed in 11 (42%). Ten (38%) patients showed no improvement. Twenty-two (51%) patients died, including 18 (42%) CNPA-related deaths, during a median follow-up of 15 months (IQR 2.5-32 months). The median survival time was 62 months. CONCLUSIONS: CNPA is difficult to treat and often has a poor outcome. Further studies with more patients are needed to identify the optimal therapy for patients with CNPA. |
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Authors:
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Hae-Seong Nam; Kyeongman Jeon; Sang-Won Um; Gee Young Suh; Man Pyo Chung; Hojoong Kim; O Jung Kwon; Won-Jung Koh |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-11-11 |
Journal Detail:
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Title: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases Volume: 14 ISSN: 1878-3511 ISO Abbreviation: Int. J. Infect. Dis. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-20 Completed Date: 2010-09-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9610933 Medline TA: Int J Infect Dis Country: Canada |
Other Details:
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Languages: eng Pagination: e479-82 Citation Subset: IM |
Copyright Information:
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Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Aged Amphotericin B / administration & dosage, therapeutic use* Antifungal Agents / administration & dosage, therapeutic use* Cohort Studies Drug Administration Schedule Female Humans Injections, Intravenous Invasive Pulmonary Aspergillosis / drug therapy* Itraconazole / administration & dosage, therapeutic use* Male Medical Records Middle Aged Republic of Korea Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antifungal Agents; 1397-89-3/Amphotericin B; 84625-61-6/Itraconazole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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