[Clinical features of eight cases of opportunistic fungal pneumonias].
We evaluated eight cases of pulmonary mycosis in immuno compromised hosts. The underlying diseases were lung cancer with chemotherapy in one case, post bone marrow transplantation (post BMT) in two cases, acquired immunodeficiency syndrome (AIDS) in one case and bronchial asthma with massive steroid therapy in four cases. The causative fungi were Candida sp. in three cases, Aspergillus sp. in four cases, Tricosporon sp. in one case. Prognosis was guarded despite antifungal treatment. Five cases deteriorated and died of fungal infection. In five cases, who died of deterioration, 31.6 days was required from appearance of abnormal infiltration in the chest X-ray to determination of the causative fungi (including two cases who were diagnosed by autopsy) on the average. In three successfully treated cases, the average duration from the appearance of abnormal infiltration in the chest X-ray for the determination of the causative fungi was 8.3 days. On the contrary, the average duration between the appearance of abnormal infiltration in the chest X-ray and the initiation of antifungal treatment was 2.6 days who died of deterioration and 8.3 days who survived. We conclude that early identification of causative fungi and not quick institution of antifungal treatment was mandatory in the treatment of opportunistic fungal pneumonia.
Urakami
R
R
Fourth Department of Internal Medicine, Kinki University School of Medicine, Osakasayama, Japan.
Nagasaka
Y
Y
Tohda
Y
Y
Ohishi
M
M
Nakajima
S
S
Fukuoka
M
M
D017088:AIDS-Related Opportunistic Infections / Q000209:etiology; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy; D016026:Bone Marrow Transplantation; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007108:Immune Tolerance; D008172:Lung Diseases, Fungal / Q000209:etiology*; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects; D008875:Middle Aged; D009894:Opportunistic Infections / Q000209:etiology*; D011014:Pneumonia / Q000209:etiology*
D005938:Glucocorticoids; D008775:Methylprednisolone