title: [Mixed types of pulmonary aspergillosis].
abstract: OBJECTIVE
  To describe the clinical features of mixed types of pulmonary aspergillosis (MTPA), and therefore to improve the diagnosis and treatment of MTPA.
  
  
  METHODS
  This study retrospectively analyzed 3 patients with MTPA in Peking University First Hospital from November 2010 to 2012. "Invasive pulmonary aspergillosis (IPA), pulmonary aspergilloma, allergic bronchopulmonary aspergillosis (ABPA)" were used as the Chinese and English keywords, to search the literatures from Wanfang database and Pubmed database until to May 2014.
  
  
  RESULTS
  There were 3 patients with MTPA, respectively with aspergilloma and IPA (patient 1), ABPA and IPA (patient 2), aspergilloma and IPA (patient 3). The cultures of respiratory secretions of the patients all yielded A.fumigatus. Patient 1 was treated by amphotericin B; Patient 2 was treated by intravenous itraconazole and glucocorticoid; Patient 3 was treated by oral voriconazole and inhaled corticosteroid, and the aspergilloma was surgically removed at the same time. Eventually, patients 1 and 2 died, while the symptoms of patient 3 were significantly improved. Drug sensitivity test of A. fumigatus showed resistance to amphotericin B or itraconazole. By far there was no concept of MTPA in the literatures and there were only 3 relevant case reports.
  
  
  CONCLUSIONS
  MTPA is a new subtype of pulmonary aspergillosis, which is more complicated and severe, and perhaps with drug resistance. MTPA should be treated by comprehensive therapies on the basis of sensitive and effective antifungal drugs.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China. Email: muxiangdong@medmail.com.cn.
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Mu
authors.forename: Jin
authors.initials: J
authors.lastname: Yu
authors.forename: Ligong
authors.initials: L
authors.lastname: Nie
authors.forename: Yuan
authors.initials: Y
authors.lastname: Cheng
authors.forename: Guangfa
authors.initials: G
authors.lastname: Wang
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000473:pathology; D001232:Aspergillus fumigatus / Q000187:drug effects; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000473:pathology; D055732:Pulmonary Aspergillosis / Q000145:classification* / Q000473:pathology; D012189:Retrospective Studies; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D005938:Glucocorticoids; D000666:Amphotericin B; D065819:Voriconazole