The Clinical Characteristics, Therapeutic Outcome and Prognostic Factors for Invasive Pulmonary Aspergillosis: A Single-Center Experience and Review of the Literature.
- Author:
Se Yoon PARK
1
;
Eun Jung LEE
;
Tae Hyong KIM
;
Eun Ju CHOO
;
Min Huok JEON
;
Min Gyu KONG
;
Jin Woo CHOO
Author Information
1. Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Seoul, Korea. shegets@schmc.ac.kr
- Publication Type:Original Article
- Keywords:
Invasive pulmonary aspergillosis
- MeSH:
Amphotericin B;
Fever;
Hematologic Neoplasms;
Humans;
Invasive Pulmonary Aspergillosis;
Lost to Follow-Up;
Neutropenia;
Pyrimidines;
Retrospective Studies;
Thorax;
Treatment Outcome;
Triazoles
- From:Korean Journal of Medical Mycology
2012;17(1):17-24
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Despite advances in microbiological diagnosis and effective antifungal treatment, invasive pulmonary aspergillosis (IPA) is a still major cause of mortality in immunocompromised patients. OBJECTIVE: The aim of this study is to analyze clinical characteristics, treatment outcome and prognostic factors for IPA. METHODS: Between May 2003 and March 2011, we retrospectively studied all patients with IPA in our facility. RESULTS: A total 37 cases were identified. Hematologic malignancies were the leading underlying disease for 27 (27/37, 73.0%) patients. Neutropenic period between the onset of neutropenia and the diagnosis of IPA was 15.0 days. The most common symptom was fever (35/37, 94.6%). The principal findings of chest computed tomography (CT) were segmental or air space consolidation (17/37, 45.9%) followed by halo sign (13/37, 35.1%), and ground-glass attenuation (11/37, 29.7%). Amphotericin B was the initial treatment for 36 (36/37, 97.3%) patients. Voriconazole was subsequently substituted for Amphotericin B in 25 (35/36, 97.2%) patients. The 30-day mortality rate was 24.3% (9/37). The 30-day mortality rate was associated with a failure to recover from neutropenia (p=0.048) or persistent fever during treatment (p=0.003). Two patients were lost to follow-up. Overall mortality was 62.9% (22/35). CONCLUSION: IPA remains a serious condition with failure to recover from neutropenia or persistent fever during treatment associated with a high 30-day mortality rate.
