[Chronic necrotizing pulmonary aspergillosis: infrequent form of aspergillosis].
BACKGROUND
Chronic necrotizing pulmonary aspergillosis (CNPA) is a chronic pulmonary infection caused by the genus Aspergillus, which usually involves moderately immunosuppressed patients.


METHODS
We describe 3 patients with a toxic syndrome that had lasted several weeks or months, with lung infiltrates in the chest X-ray and the CT scan. Mycobacterium tuberculosis could not be isolated from different respiratory smears (sputum, bronchoaspiration, Barlett catheter and pulmonary punction in the third case). Moreover, there was no response to anaerobic treatment.


RESULTS
All 3 patients were moderately immunosuppressed (2 men were COPD and the woman was an asthmatic patient). One of the men was being treated for a nocardiosis. In all three cases, A. fumigatus was isolated from de different respiratory smears.


CONCLUSIONS
To diagnose a CPNA, a high degree of clinical suspicion is needed. The differential diagnose should be done with pulmonary tuberculosis and anaerobic infections. The presence of a member of the genus Aspergillus in the tracheobronchial secretions of a patient should not be systematically considered a saprofit, specially when other microorganisms can not be isolated.
Navarro
M
M
Servicio de Neumología, Hospital del Parc Taulí, Sabadell, Barcelona.
Domingo
C
C
Gallego
M
M
Roig
J
J
Mariscal
D
D
Marín
A
A
D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000175:diagnosis / Q000628:therapy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009336:Necrosis
Aspergilosis pulmonar necrosante crónica: una forma infrecuente de infección por Aspergillus.