Source: International Congress 2014 – Different interesting issues in respiratory infections: 1
Disease area: Interstitial lung diseases, Respiratory infections

Abstract

Background: The number of patients with pulmonary aspergillosis occurring with interstitial pneumonia (IP) is increasing. In addition to the difficulty in diagnosis of asperigillosis in the destructed lung by IP, aspergillosis might complicate management of chronic interstitial pneumonia when considering immunosuppressive therapy.Object: To elucidate clinicopathological characteristics of pulmonary aspergillosis in the lung with chronic interstitial pneumonia and of IP infected with Aspergillus.Materials and Methods: Patients diagnosed by pathology as pulmonary aspergillosis infected in the IP lung between April 1, 1990 and March 31, 2013 was included in this study. We retrospectively reviewed medical records for clinical and radiological findings as well as pathological findings.Results: Registered cases consisted of 4 surgical resection and 14 autopsies with 13 males and 5 females. Positive aspergillus antigen was detected in 7/14, and positive aspergillus antibody in 7/17. All of the isolated fungi were Aspergillus fumigatus.Chronic interstitial pneumonia was 9 idiopathic and 9 secondary cases. Histological findings revealed 13 UIP, 1 fNSIP and 4 unclassified cases. Steroid therapy was administered in12/18 and immunosuppressant in 6/18. Although 17 cases were consistent with chronic pulmonary aspergillosis, 1 case was consistent with invasive pulmonary aspergillosis.Conclusion: During follow-up of chronic interstitial pneumonia, especially UIP pattern, possibility of Aspergillus infection must be considered. In addition to the radiological findings, antigen and antibody measurement together with sputum culture might be helpful to confirm the diagnosis.

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M. Shimada, A. Hebisawa, J. Suzuki, H. Matsui, A. Tamura, T. Fukami, K. Ohta (Kiyose, Japan). Clinicopathological features of the pulmonary aspergillosis with chronic interstitial pneumonia. Eur Respir J 2014; 44: Suppl. 58, 2556

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