Clinical evaluation of 61 patients with pulmonary aspergilloma.
OBJECTIVE
We retrospectively evaluated 61 cases with pulmonary aspergilloma representing patients admitted to Nagasaki University Hospital between January 1991 to June 1998.


RESULTS
Fifty-two (85%) were males and 9 (15%) were females, aged between 14 to 80 years (average, 65 years). Forty-four (72%) patients had history of old pulmonary tuberculosis. Chest radiographs showed "fungus ball" in the cavities in 42 (67%) cases while 16 (26%) cases showed thickening of the cavity wall. Aspergillus fumigatus was isolated in 24 (39%) patients. Aspergillus antigen or antibody was positive in 8 (13%) and 43 (70%) patients, respectively. Oral itraconazole was used in 16 (26%) of patients, and surgical excision was performed in 15 (25%) patients. During hospitalization or after discharge, 19 (31 %) patients died.


CONCLUSIONS
Pulmonary aspergilloma usually occurs in elderly patients with old tuberculosis and respiratory failure. Many cases did not respond to antifungal therapy with itraconazole or amphotericin B. Our analysis indicates that more effective and appropriate therapeutic regimens are needed for the treatment of patients with pulmonary aspergilloma.
Kawamura
S
S
Second Department of Internal Medicine, Nagasaki University School of Medicine.
Maesaki
S
S
Tomono
K
K
Tashiro
T
T
Kohno
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use*; D000908:Antibodies, Fungal / Q000032:analysis; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D001230:Aspergillus / Q000276:immunology / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications
D000908:Antibodies, Fungal; D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B