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| Clinical features and prognosis of invasive tracheobronchial aspergillosis in non-lung transplantation hosts |
| SU Shanshan1, ZHOU Ying1, OUYANG Jinsheng1, HE Haidong1, LIN Pengcheng1, WU Qing2, LI Yuping1. |
1.Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 2.Clinical Laboratory Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015
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SU Shanshan,ZHOU Ying,OUYANG Jinsheng, et al. Clinical features and prognosis of invasive tracheobronchial aspergillosis in non-lung transplantation hosts[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(2): 79-83,87.
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Abstract Objective: To explore the clinical features and prognosis of invasive tracheobronchial aspergillosis (ITBA) in non-lung transplantation hosts. Methods: Nineteen cases of non-lung transplantation who admitted to the department of pulmonary and critical care medicine of the First Affiliated Hospital of Wenzhou Medical University from March 2002 to June 2015, for whom ITBA were confirmed by microbiologic culture and histopathology, were enrolled and all data were retrospectively analyzed. Results: Chronic respiratory diseases (CRD), diabetes mellitus and malignant tumor were the most common underlying diseases. ITBA could be diagnosed in immunocompetent host. In non-lung transplantation and non-malignant tumor hosts, at first, isolated tracheobronchitis was the most common manifestation, pseudomembranous form of ITBA was the major appearance under bronchoscopy. With the diseases progression, different features and extent of pulmonary involvement could be seen, ulcerative tracheobronchitis increased significantly, the total mortality was 52.6%, mortality increased to 100% when received mechanical ventilation. In patients with hematological malignancies, ITBA was often with IPA, under bronchoscopy, ulcerative and pseudomembranous forms of lobar bronchi were present in 2 cases, another patient of metastatic lung cancer who received radiotherapy, ITBA was also located in middle lobe and ulcerative form. Two of three patients died of massive hemoptysis. Conclusion: CRD, diabetes mellitus and malignant tumor are the most common underlying diseases of ITBA in non-lung transplantation hosts, it can also occur in immunocompetent host. Isolated tracheobronchitis and pseudomembranous form are the initial manifestations; In patients with hematological malignancies, ITBA is often with IPA, ulcerative and pseudomembranous forms of drainage bronchi were present. ITBA with underlying diseases have poor prognosis.
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Received: 14 September 2015
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