title: Clinical characteristics and treatment outcomes of chronic pulmonary aspergillosis.
abstract: Chronic pulmonary aspergillosis (CPA) is a relatively uncommon disease that has been poorly characterized. This study investigated the clinical features and treatment outcomes of CPA through a retrospective review of records of patients with newly diagnosed CPA between January 2008 and January 2012. A total of 70 CPA patients, which included 51 (73%) males, had a median age of 55 years. Fifty-seven patients (81%) had a history of pulmonary tuberculosis and pulmonary disease caused by nontuberculous mycobacteria (NTM) was a primary underlying condition in 32 patients (46%). Most patients (n = 66; 99%) were treated with oral itraconazole, for a median of 6.4 months. Treatment response of 73% of patients was based on alleviation of symptoms and in 44% on computed tomography. Laboratory tests improved for more than 60% of patients and overall favorable responses were achieved in 44 patients (62%). Five of the latter (11%) had to restart antifungal therapy after a median of 9.2 months after therapy. Death occurred in 10 patients (14%). This study suggested that NTM lung disease was an important risk factor for CPA development. While treatment with oral itraconazole for approximately 6 months was moderately effective in treating CPA, a more effective treatment is required.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
authors.forename: Byung Woo
authors.initials: BW
authors.lastname: Jhun
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.forename: Jung Seop
authors.initials: JS
authors.lastname: Eom
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000150:complications; D055732:Pulmonary Aspergillosis / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole