Chest
Aspergillosis of the Lung - An Eighteen-Year Experience
Section snippets
MATERIALS AND METHODS
This study represents 21 patients with aspergillosis of the lung admitted to the Veterans Administration Hospital between 1951 and 1969. Of the 21, nine were treated surgically, one medically, and 11 received no specific treatment.
Surgical treatment consisted of lobectomy in seven, pneumonectomy in one, and segmental resection in one. Specific medical treatment consisting of endocavitary infusions of amphotericin B and sodium iodide through a percutaneously placed endobronchial catheter was
RESULTS
In the present series of nine surgically resected patients, all have remained free of disease for periods from five months to 18 years. There was no operative death. Complications occurred in two, one with empyema following pneumonectomy, which was corrected by a modified Schede thoracoplasty, and the other a residual pleural space which responded to prolonged thoracotomy tube drainage.
The only medically treated patient is doing well one year following endocavitary infusions of amphotericin B
DISCUSSION
Several authorities have discussed the spectrum of Aspergillus infections and have suggested classifications.3, 4, 5, 6 We have tended to use the classification as suggested by Hinson et al3 in which the infections may be divided into saprophytic, allergic, and pyemic (disseminated) varieties. Our cases have belonged generally to the saprophytic group, with an occasional patient showing active lung invasion as a terminal event.
The clinical findings were varied and depended upon the associated
REFERENCES (13)
- et al.
Endocavitary infusion through percutaneous endobronchial catheter
Chest
(1970) - et al.
Aspergillosis. A review and report of twelve cases
Amer J Med
(1959) Radiological appearances in pulmonary aspergillosis
Clin Radiol
(1962)- et al.
Surgery for pulmonary aspergillosis
J Thorac and Cardiovas Surg
(1969) - et al.
Primary pulmonary aspergillosis: Report of an unusual case successfully treated by lobectomy
Ann Surg
(1956) - et al.
Bronchopulmonary aspergillosis
Thorax
(1952)
Cited by (78)
The biology of pulmonary aspergillus infections
2014, Journal of InfectionCitation Excerpt :An aspergilloma may exist for years without causing symptoms and comes to clinical attention as an incidental finding. Although, most patients will experience mild hemoptysis resulting from local hyphal invasion of blood vessels lining the cavity or by mechanical friction of the aspergilloma with the cavity wall blood vessels.43,44 Allergic bronchopulmonary aspergillosis is a hypersensitivity reaction to Aspergillus antigens and is a well-recognized complication of CF. Incidence rates vary between 2 and 15% and it usually affects adolescents and adults with CF.45,46 Inhaled conidia are trapped in the thick mucus layer covering the bronchial epithelial cell layer and their continued presence stimulates the release of inflammatory mediators.
Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease
2014, Revista Iberoamericana de MicologiaPulmonary aspergilloma with good antifungal response
2009, Revista de Patologia RespiratoriaAspergillus-related lung disease
2008, Respiratory Medicine CMECitation Excerpt :Sometimes these patients are asymptomatic; however, up to 75% of patients present with hemoptysis98 or productive cough, chest pain, dyspnea, fever, weight loss, or clubbing. Life threatening bleeding may occur from bronchial blood vessels, and may be due to local invasion of blood vessels lining the cavity, endotoxins released from the fungus, or mechanical irritation of the exposed vasculature inside the cavity.99–101 Although aspergillomas are usually single, they may also be present bilaterally.
The clinical spectrum of pulmonary aspergillosis
2002, ChestCitation Excerpt :Bleeding usually occurs from bronchial blood vessels. Theories on the cause of the hemoptysis include local invasion of blood vessels lining the cavity, endotoxins released by the fungus with hemolytic properties, and mechanical friction of the aspergilloma with the cavity wall blood vessels.2,14,15 The mortality rate from hemoptysis ranges between 2% and 14%.16,17,18,19,20
The purpose of this report is to review our experience with 21 patients with aspergillosis and to show certain unusual features associated with this disease.