Clinical manifestation of chronic cavitary pulmonary aspergillosis

Abstract

Objective To discuss the clinical manifestation,imaging characteristic,diagnosis and treatment of chronic cavitary pulmonary aspergillosis(CCPA).Methods Clinical data of three patients with CCPA were summarized,who had ever been misdiagnosed as pulmonary tuberculosis for a long time and failed to treatment with antituberculosis drugs,even aggravated to have lung injury,and were pathologically confirmed as CCPA by surgery or transbronchial lung biopsy.Results Chronic cough,fatigue,or short breath were common clinical symptoms of CCPA.Imaging results showed that cavitary lesions appeared in the upper lobe of lung,which increased progressively,and sometimes were multiple.Histological examination showed that fungal hyphae cound be found in the cavity,chronic inflammation and pulmonary fibrosis appeared in surrounding lung tissue,accompanying pleural thickening.Conclusions CCPA is a subtype of chronic pulmonary aspergillosis,which is rare in clinic.The imaging characteristic is mainly that cavitary lesions increase progressively.Fungal hyphae can be found in the cavity by histological examination.For CCPA patients,antifungal therapy should be taken actively,and surgery can be taken if necessary. Key words: Chronic; Cavity; Pulmonary; Aspergillus