Clinical Analysis Of Invasive Pulmonary Aspergillosis

Objective:To describe the clinical manifestation,diagnosis and treatment of Invasive pulmonary aspergillosis.Methods:A retrospective analysis of 5 cases with confirmed invasive pulmonary aspergillosis,All patients were admitted to Respiratory Department of Sir Run Run Shaw Hospital,Medical School of Zhejiang University, during 2005～2008.Results:5 patients,three males,two females,averagely aged 61.8 years.The symptoms manifested were cough(4/5,80%),sputum(4/5,80%),fever (3/5,60%),chest pain(0/5,0%)and hemoptysis(3/5,60%).Four patients with underlying diseases(including COPD,Diabetes Mellitus,alcoholic liver disease,tuberculosis, etc),one without underlying diseases.Chest CT scans showed that two patients with multiple cavities formation in bilateral lungs,one with lung consolidation shadow and cavity formation in unilateral lung,one with multiple lung consolidation shadows in both lungs and one with a solitary swelling shadow in one lung.Three patients' diagnosis were confirmed by CT-guided percataneous cutting needle biopsy(PCNB ).The other two were diagnosed by combined their underlying diseases,typical clinical manifestations and the Repeated positive sputum culture results of Aspergillus.All patients accepted antifungal agent treatment,four were cured,one died.Conclusion: The clinical manifestations of IPA are nonspecific.High resolution CT scan plays an important role in diagnoses,but pathological evidence is needed to confirm the diagnosis.The outcome depends on early diagnosis,the patient's underlying diseases, immunologic function,and powerful antifungal agent treatment.