Clinicial analysis of chronic pulmonary aspergillosis in 28 cases
1.Department of Respiratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 2.Department of Respiratory Medicine, Wenzhou Central Hospital, Wenzhou, 325000
DONG Shuangxia1,2,ZHENG Jiyang2, et al. Clinicial analysis of chronic pulmonary aspergillosis in 28 cases[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(10 ): 765-.
Abstract：Objective: To study the clinical features and method of diagnosis and treatment in chronic pulmonary aspergillosis. Methods: Twenty-eight cases of chronic pulmonary aspergillosis from May 2010 to Feb 2015 in Wenzhou Central Hospital were retrospectively analyzed. Results: Twenty-four cases had basic disease or mildly immunodepression, in whom the most common was pulmonary tuberculosis and the followed by was bronchiectasis. There was no specificity in clinical manifestations, the common presentations included productive cough, haemoptysis.Imaging examination showed the diseased region mainly located in upper lobe, the main characteristic lesion, were pulmonary cavity with aspergills ball, inflitrating shadows around, pleural thickening, and the air crescent sign founded in 10 cases. Nine cases were pathologically diagnosed by surgery or lung puncture, and 19 cases were diagnosed by bronchoalveolar lavage fluid or sputum culture. The antifungal therapy was given in 19 cases, which improved symptoms in 17 cases and cured in 2 cases. Surgery treatment performed in 6 cases, and 4 cases of them with good prognosis. Conclusion: Lacking specificity of clinical manifestations, it is easy to be misdiagnosed and missed diagnosis. Imaging examination plays an important role in disease diagnosis, and making a definite diagnosis requires pathological or etiological foundation. Patients with complete lesion resection and in good condition recommended surgery as soon as possible, others needed the anti-fungal treatment to improve the outcome.
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