title: Clinical features of pulmonary aspergillosis associated with interstitial pneumonia.
abstract: OBJECTIVE
  We retrospectively investigated the clinical features of pulmonary aspergillosis associated with interstitial pneumonia.
  
  
  METHODS
  We reviewed the medical records of all patients treated for interstitial pneumonia with or without pulmonary aspergillosis at our institution between April 2006 and August 2012 and evaluated the clinical features as well as risk and prognostic factors for pulmonary aspergillosis associated with interstitial pneumonia.
  
  
  RESULTS
  Among 539 patients with interstitial pneumonia, 15 who suffered from pulmonary aspergillosis were identified. The median age was 69.2±7.0 years, and fourteen patients were men. The subtypes of pulmonary aspergillosis were chronic pulmonary aspergillosis (n=14) and invasive pulmonary aspergillosis (n=1). The forms of interstitial pneumonia included idiopathic pulmonary fibrosis (n=9), rheumatoid arthritis-related interstitial pneumonia (n=4) and pleuroparenchymal fibroelastosis (n=2). The underlying conditions were emphysema (n=9) and a history of oral corticosteroid and/or immunosuppressive use (n=4). Home oxygen therapy (HOT) was administered in 11 patients. Following the diagnosis of pulmonary aspergillosis, all patients were treated with antifungal drugs. Ten patients (66.6%) died. A comparison of the interstitial pneumonia patients with and without pulmonary aspergillosis showed that the presence of emphysema, use of HOT and death were significantly associated with pulmonary aspergillosis.
  
  
  CONCLUSIONS
  Pulmonary aspergillosis is one of the major complications of interstitial pneumonia and its prognosis is poor. Therefore, providing careful monitoring and proper treatment is extremely important.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Kurosaki
authors.forename: Masashi
authors.initials: M
authors.lastname: Bando
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Naoko
authors.initials: N
authors.lastname: Mato
authors.forename: Takakiyo
authors.initials: T
authors.lastname: Nakaya
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yamasawa
authors.forename: Taichiro
authors.initials: T
authors.lastname: Yoshimoto
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Fukushima
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sugiyama
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055732:Pulmonary Aspergillosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents