Document Detail

Clinical characteristics and treatment outcomes of chronic necrotizing pulmonary aspergillosis: a review of 43 cases.
MedLine Citation:
PMID:  19910234     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-11
Journal Detail:
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:
Created Date:  2010-05-20     Completed Date:  2010-09-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e479-82     Citation Subset:  IM    
Copyright Information:
Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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MeSH Terms
Administration, Oral
Amphotericin B / administration & dosage,  therapeutic use*
Antifungal Agents / administration & dosage,  therapeutic use*
Cohort Studies
Drug Administration Schedule
Injections, Intravenous
Invasive Pulmonary Aspergillosis / drug therapy*
Itraconazole / administration & dosage,  therapeutic use*
Medical Records
Middle Aged
Republic of Korea
Retrospective Studies
Treatment Outcome
Reg. No./Substance:
0/Antifungal Agents; 1397-89-3/Amphotericin B; 84625-61-6/Itraconazole

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