The Journal of international medical research · 2019
Clinical manifestations and outcome analysis of invasive pulmonary aspergillosis infection: a retrospective study in 43 nonneutropenic patients.
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Zhang Lihong, Che Chunli
Аннотация
OBJECTIVE: To investigate clinical characteristics of early-onset invasive pulmonary aspergillosis (IPA) in nonneutropenic patients.
METHODS: Retrospective analysis was used to investigate clinical manifestations and auxiliary examination characteristics in 43 patients with IPA and 51 patients with community-acquired pneumonia in the early stage.
RESULTS: Risk factors of IPA were dust and mold exposure, bronchiectasis, old pulmonary tuberculosis, and nasosinusitis. The incidence rate of complex clinical manifestations was 60.47% during the first week of IPA. The incidence rate of white blood cell (WBC) count >20.0 × 109/L was 51.16%. Lung CT findings indicated incidence rates of single or multiple nodules with a halo sign and central airway expansion with ground glass opacity were 27.9% and 37.21%, respectively. Mortality rates of patients with IPA given empirical and targeted antifungal treatments were 12.0% and 42.9%, respectively.
CONCLUSIONS: Bronchiectasis, old pulmonary tuberculosis, nasosinusitis, and dust and mold exposure may increase the risk of IPA. Single or multiple nodules with a halo sign and central airway expansion with ground glass opacity may be early-stage lung CT findings in patients with IPA. A WBC count >20.0 × 109/L may aid in early diagnosis, and empirical antifungal therapy may reduce mortality in patients with IPA.
METHODS: Retrospective analysis was used to investigate clinical manifestations and auxiliary examination characteristics in 43 patients with IPA and 51 patients with community-acquired pneumonia in the early stage.
RESULTS: Risk factors of IPA were dust and mold exposure, bronchiectasis, old pulmonary tuberculosis, and nasosinusitis. The incidence rate of complex clinical manifestations was 60.47% during the first week of IPA. The incidence rate of white blood cell (WBC) count >20.0 × 109/L was 51.16%. Lung CT findings indicated incidence rates of single or multiple nodules with a halo sign and central airway expansion with ground glass opacity were 27.9% and 37.21%, respectively. Mortality rates of patients with IPA given empirical and targeted antifungal treatments were 12.0% and 42.9%, respectively.
CONCLUSIONS: Bronchiectasis, old pulmonary tuberculosis, nasosinusitis, and dust and mold exposure may increase the risk of IPA. Single or multiple nodules with a halo sign and central airway expansion with ground glass opacity may be early-stage lung CT findings in patients with IPA. A WBC count >20.0 × 109/L may aid in early diagnosis, and empirical antifungal therapy may reduce mortality in patients with IPA.