Clinical Characteristics and Treatment Outcomes of Chronic Pulmonary Aspergillosis: a Retrospective Analysis of 70 Patients = Clinical Characteristics and Treatment Outcomes of Chronic Pulmonary Aspergillosis: a Retrospective Analysis of 70 Patients

다국어 초록 (Multilingual Abstract)

Backgroud: Chronic pulmonary aspergillosis (CPA) is uncommon and there are few data on the clinical characteristics, optimal therapeutic strategies, and outcomes. Methods: We retrospectively reviewed the records of patients with newly diagnosed CPA and assessed the clinical, radiologic, and laboratory responses, and outcomes between January 2008 and January 2012. Results: A total of 70 CPA patients were included. Median age was 55 years and 51 patients (72.9% ) were men. Fifty-seven patients (81.4%) had a history of pulmonary tuberculosis and 32 patients (45.7%) had non-tuberculosis mycobacterium (NTM) lung disease, 17 of whom had a history of NTM treatment and 15 was under NTM treatment. Sixty-nine patients (98.6%) received oral itraconazole, except one with oral voriconazole for a median duration of 6.2 months. Symptomatic improvement occurred in 52 patients (74.3%), radiologic improvement occurred in 29 (41.4%), and laboratory tests improved more than 60% of all patients. Thirty-six patients (51.4%) achieved treatment success, defined as symptomatic improvement after at least 6 months of therapy regardless of radiological improvement, and 4 of whom needed retreatment after a median of 8.4 months. There was no difference in clinical characteristics and outcomes according to NTM status and 10 (14.3%) discontinued therapy due to adverse reactions. Death occurred in 10 (14.3%) and median follow-up duration was 11.2 months. Conclusion: Antifungal therapy for about 6 months and reassessment of disease might be feasible treatment strategy in managing patients with CPA.