The Clinical Characteristics, Therapeutic Outcome and Prognostic Factors for Invasive Pulmonary Aspergillosis: A Single-Center Experience and Review of the LiteratureThe Clinical Characteristics, Therapeutic Outcome and Prognostic Factors for Invasive Pulmonary Aspergillosis: A Single-Center Experience and Review of the Literature
- Other Titles
- The Clinical Characteristics, Therapeutic Outcome and Prognostic Factors for Invasive Pulmonary Aspergillosis: A Single-Center Experience and Review of the Literature
- Authors
- 박세윤; 이은정; 김태형; 추은주; 전민혁; 공민규; 주진우
- Issue Date
- 2012
- Publisher
- 대한의진균학회
- Keywords
- Invasive pulmonary aspergillosis
- Citation
- 대한의진균학회지, v.17, no.1, pp.17 - 24
- Journal Title
- 대한의진균학회지
- Volume
- 17
- Number
- 1
- Start Page
- 17
- End Page
- 24
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/15909
- DOI
- 10.17966/jmi.2012.17.1.17
- ISSN
- 1226-4709
- 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.
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