| Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease. | |
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MedLine Citation:
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PMID: 17906086 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Aspergillus spp. cultured in specimens from the airways of chronic obstructive pulmonary disease (COPD) patients are frequently considered as a contaminant. However, growing evidence suggests that severe COPD patients are at higher risk of developing invasive pulmonary aspergillosis (IPA), although IPA incidence in this population is poorly documented. Some data report that COPD is the underlying disease in 1% of patients with IPA. Definitive diagnosis of IPA in COPD patients is often difficult as tissue samples are rarely obtained before death. Diagnosis is therefore usually based on a combination of clinical features, radiological findings (mostly thoracic computed tomography scans), microbiological results and, sometimes, serological information. Of 56 patients with IPA reported in the literature, 43 (77%) were receiving corticosteroids on admission to hospital. Breathlessness was always a feature of disease and excess wheezing was present in 79% of patients. Fever (>38 degrees C) was present in only 38.5%. Chest pain and haemoptysis were uncommon. Six out of 33 (18%) patients had tracheobronchitis observed during bronchoscopy. The median delay between symptoms and diagnosis was 8.5 days. The mortality rate was high: 53 out of 56 (95%) patients died despite invasive ventilation and antifungal treatment in 43 (77%) of them. In chronic obstructive pulmonary disease patients, invasive pulmonary aspergillosis currently carries a very poor prognosis. Outcome could perhaps be improved by more rapid diagnosis and prompt therapy with voriconazole. |
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Authors:
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P Bulpa; A Dive; Y Sibille |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The European respiratory journal Volume: 30 ISSN: 0903-1936 ISO Abbreviation: Eur. Respir. J. Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-10-01 Completed Date: 2008-01-14 Revised Date: 2013-05-23 |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: Switzerland |
Other Details:
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Languages: eng Pagination: 782-800 Citation Subset: IM |
Affiliation:
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Intensive Care Unit, Mont-Godinne University Hospital, Université Catholique de Louvain, 5530, Yvoir, Belgium. pierre.bulpa@rean.ucl.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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pharmacology Aged Antifungal Agents / pharmacology Aspergillosis, Allergic Bronchopulmonary / complications*, epidemiology, microbiology, mortality Aspergillus / metabolism* Bronchoscopy / methods Female Humans Lung Diseases, Fungal / diagnosis, microbiology, mortality Male Middle Aged Prognosis Pulmonary Disease, Chronic Obstructive / complications*, epidemiology, microbiology, mortality Sputum / microbiology Tomography, X-Ray Computed Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Antifungal Agents |
| Comments/Corrections | |
Erratum In:
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Eur Respir J. 2007 Dec;30(6):1236 |
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