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Pseudomembranous and obstructive Aspergillus tracheobronchitis - optimal diagnostic strategy and outcome
Selçuk Tasci1, Axel Glasmacher, Silvia Lentini
1Department of Internal Medicine II, University of Bonn, Germany. selcuk.tasci@ukb.uni-bonn.de
Mycoses
|December 22, 2005
Summary
Pseudomembranous and obstructive Aspergillus tracheobronchitis (PMATB/OATB) have a poor prognosis. Microscopy of respiratory specimens is the most sensitive diagnostic tool, enabling prompt antifungal therapy.
Area of Science:
- Medical Mycology
- Pulmonology
- Infectious Diseases
Background:
- Pseudomembranous and obstructive Aspergillus tracheobronchitis (PMATB/OATB) are severe fungal infections of the airways.
- These conditions are often refractory to treatment and associated with high mortality rates.
Observation:
- A retrospective analysis of 20 cases (4 new, 16 reported) between 1995-2004 was conducted.
- Ventilated patients had a significantly higher mortality rate (94%) compared to non-ventilated patients (25%).
Findings:
- Diagnosis was established via bronchoscopy in all patients.
- Microscopy of mucous plugs and/or necrotic material demonstrated the highest diagnostic yield (94%).
- Culture of mucous plugs and tracheobronchial aspirates showed positive results in 80% and 67% of cases, respectively.
Implications:
- Despite poor prognosis, early diagnosis via microscopy allows for immediate antifungal treatment.
- Non-invasive diagnostic methods and prompt treatment are crucial for improving outcomes in PMATB/OATB.
