title: [Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease].
abstract: Invasive pulmonary aspergillosis (IPA) is a common infection in immunocompromised patients with hematological malignancies or allogenic stem cell transplantation, and is less frequent in the context of chronic obstructive pulmonary disease (COPD). Mucociliary activity impairment, immunosuppression due to the inhibition of alveolar macrophages and neutrophils by steroids, and receiving broad-spectrum antibiotics, play a role in the development of IPA in COPD patients. Colonized patients or those with IPA are older, with severe CODP stage (GOLD≥III), and have a higher number of comorbidities. The mortality rate is high due to the fact that having a definitive diagnosis of IPA in COPD patients is often difficult. The main clinical and radiological signs of IPA in these types of patients are non-specific, and tissue samples for definitive diagnosis are often difficult to obtain. The poor prognosis of IPA in COPD patients could perhaps be improved by faster diagnosis and prompt initiation of antifungal treatment. Some tools, such as scales and algorithms based on risk factors of IPA, may be useful for its early diagnosis in these patients.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Montepríncipe, Universidad San Pablo-CEU, Madrid, España. Electronic address: josebarberan@telefonica.net.
authors.forename: José
authors.initials: J
authors.lastname: Barberán
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, España.
authors.forename: José
authors.initials: J
authors.lastname: Mensa
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000935:Antifungal Agents / Q000627:therapeutic use; D057210:Delayed Diagnosis; D006801:Humans; D016867:Immunocompromised Host; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D009172:Mycology / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000276:immunology; D011859:Radiography; D012307:Risk Factors; D015163:Superinfection
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000935:Antifungal Agents
keywords: Anfotericina B liposómica; Aspergilosis pulmonar invasiva; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Invasive pulmonary aspergillosis; Liposomal amphotericin B; Voriconazol; Voriconazole