Surgical treatment of pulmonary aspergillosis/mycosis in immunocompromised patients.
Invasive pulmonary aspergillosis is a severe complication in immunosuppressed patients. Surgical resection can be curative in certain patients after antifungal treatment. Over a 7-year period, ten patients with suspected invasive pulmonary aspergillosis of two university hospitals were retrospectively reviewed. A literature review was undertaken. Patient's age was 48.1 years (mean); the cause of immunosuppression was a hematological disease with consecutive therapy in seven patients and chronically corticoid therapy in three patients. After an antifungal therapy, surgical resection was performed with lobectomy/segmentectomy in 60% and with wedge-resection in 40%. Postoperative course were uneventful in seven patients, two patients died due to infectional circumstances, and one patient was reoperated because of empyema. The underlying disease marked long-term follow-up. Resection of focal pulmonary invasive aspergillosis can be curative. Clinical circumstances and dissemination must be taken into consideration to indicate surgery. To point out the best pathway randomised prospective studies are necessary.
Danner
Bernhard C
BC
Department of Thoracic, Heart and Vascular Surgery, Georg August University of Göttingen, 37075 Göttingen, Germany. drdanner@arcor.de
Didilis
Vassilios
V
Dörge
Hilmar
H
Mikroulis
Dimitrios
D
Bougioukas
Georgios
G
Schöndube
Friedrich A
FA
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000276:immunology / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005858:Germany; D006115:Greece; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008172:Lung Diseases, Fungal / Q000276:immunology / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000935:Antifungal Agents; D007166:Immunosuppressive Agents