[Antimycotic treatment of pulmonary aspergilloma in patients without neutropenia].

Abstract

BACKGROUND AND OBJECTIVE:

Pulmonary aspergillomas are associated with a high morbidity and mortality. There are only very few data about non-surgical treatment in immunocompetent patients.

METHODS:

We evaluated 30 patients (19 male/11 female; mean age: 54 years) with pulmonary aspergillosis, their symptoms, treatment and outcome during a time period of 9 years. All patients had either definitive (18/60 %) or probable (12/40 %) aspergillosis with a cultural confirmation.

RESULTS:

Underlying diseases were tuberculosis (16/53 %), malignancy (8/30 %), COPD (15/50 %), pneumonia (3/10 %). Only five patients were immunocompromised (steroid medication: n = 4, chronic lymphatic leukemia: n = 1) All patients had a contraindication against surgery, 26 received antifungal treatment (mostly with voriconazole or itraconazole). The overall response was 61 %, there was an improvement of radiological signs in seven (23 %). Especially hemoptysis and dyspnea resolved. 12 patients died during the 9 years (40 %), nine from their underlying disease, three from the pulmonary aspergilloses (hemoptysis: n = 2, secondary invasive aspergillosis: n = 1).

CONCLUSION:

Pulmonary aspergilloma in its chronic form is a disease of patients with pulmonary disease but who are immunocompetent. Antifungal treatment seems to be a therapeutic option, if surgery is not possible.

• Authors: H Grysczyk, A De Roux, A Grassot, H Mauch, H Lode
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 127 Issue 10 Pg. 492-6 (Mar 08 2002) ISSN: 0012-0472 [Print] Germany
• Vernacular Title: Antimykotische Therapie pulmonaler Aspergillome bei nicht neutropenischen Patienten.
• PMID: 11884987 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antifungal Agents
• Pyrimidines
• Triazoles
• Itraconazole
• Voriconazole

Topics

• Antifungal Agents (therapeutic use)
• Aspergillosis, Allergic Bronchopulmonary (drug therapy, etiology)
• Female
• Humans
• Itraconazole (therapeutic use)
• Male
• Middle Aged
• Neutropenia
• Pyrimidines (therapeutic use)
• Retrospective Studies
• Treatment Outcome
• Triazoles (therapeutic use)
• Voriconazole