Clinical Characteristics And Comparative Study Of Pulmonary Aspergillosis And Pulmonary Cryptococcosis

Objective The clinical data of pulmonary aspergillosis and pulmonary cryptococcosis were retrospectively analyzed and compared,in order to improve the level of cognition and identification of two kinds of diseases through this research,provide the basis for accurate treatment.Method Pulmonary aspergillosis(PA)and pulmonary cryptococcosis(PC)cases diagnosed by histopathology,from October 2011 to September 2016 in the Fujian Medical University Union Hospital.The general situation,clinical symptoms and imaging information were collected and analyzed.Results 38 cases of PA and 155 cases of PC patients,the youngest was 23 and 21 years old,the oldest was 70 and 75 years old,the median age was 53 and 52 years old,two cases were almost all ages,with 50 to 59 years old while the largest incidence.On the basis of pathological specimens,the proportion of surgical resection was the largest,accounted for 94.7% and 97.4%;the anti-infective treatment(including bacteria and fungi)were 73.7% and 19.4%,which with bronchiectasis were about 36.8% and 0.6% respectively.PA and PC group were accounted for 21.1% and 57.4% in the asymptomatic ratio.On imaging,the proportion of single lesion was the largest in the PA group,with a total of 81.6%,compared with PC,multiple lesions were the most,with a total of 54.8%.PA and PC group,the rate of lesions with cavity were 50% and 9.7%.The number of patients with near pleural lesions(partial or total)was 44.7% and 61.3%,with pleural indentation were 41.2% and 30.5%.The maximum diameter of >0.8cm as well as ? 3.0cm were the most,52.6% and 69.0% respectively.Group PA lesions occur most frequently in the upper lobe,which compared with PC lesions occur in the lower lung.Compared with PA and PC group,the number of cases of age was different;The anti-infective treatment before diagnosis,the proportion of pulmonary tuberculosis,and bronchiectasis were higher in PA group;the proportionof men,and the proportion of patients with malignant or premalignant lesions found in the past or perioperative period were higher in PC group;cough,expectoration and hemoptysis / blood-streaked sputum ratios were higher in group PA;and asymptomatic ratio was higher in group PC.On imaging,the two groups in the number of lesions,size,predilection site were different.Compared with group PC,the proportion of the cavity in the PA group was higher.The above indexes were statistically analyzed,P<0.05,the difference was statistically significant.Conclusion PA and PC were mainly middle-aged.PA had a history of pulmonary tuberculosis,bronchiectasis,cough,expectoration and hemoptysis /blood-streaked sputum were more obvious.PC was more likely to be combined with malignant tumor or precancerous lesion,without clinical symptoms.The maximum diameter of >0.8cm as well as ? 3.0cm were the most in both of PA and PC.In the PA,single and cavitary lesion were more common,and tended to be in the upper lung.In the PC,multiple lesions were more common,and tended to be in the lower lung.Two kinds of diseases in more than 10 years of smoking history,diabetes,COPD,fever,chest pain,chest tightness/shortness of breath,nearly subpleural lesions and pleural indentation had no obvious difference.