Related Experiment Video
Updated: Jan 29, 2026
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Surgical management of pulmonary aspergillosis in pediatric population
Insights
Surgical intervention for pediatric pulmonary aspergillosis (PA) can improve outcomes in patients with severe invasive fungal infections. Early surgery is recommended for those with cavitating lesions unresponsive to antifungal treatment.
Area of Science:
- Medical Mycology
- Pediatric Surgery
- Infectious Diseases
Background:
- Pulmonary aspergillosis (PA) is a severe invasive fungal infection primarily affecting immunocompromised individuals.
- The lungs are the most common site of infection, posing significant challenges in pediatric cases.
Purpose of the Study:
- To review the surgical management of pulmonary aspergillosis in pediatric patients.
- To evaluate the outcomes and identify factors influencing survival in this population.
Main Methods:
- A retrospective chart review of pediatric patients (<16 years) managed for PA between January 2001 and December 2016.
- Data collected included demographics, clinical presentation, surgical procedures, and outcomes.
- Descriptive statistics were used to analyze the data.
Main Results:
- Eighty patients had proven PA, with 38 undergoing surgical intervention.
- The majority of surgical patients (92%) were immunocompromised, often post-bone marrow transplant.
- Surgical procedures varied, including biopsy, segmentectomy, lobectomy, debridement, and pneumonectomy. Mortality was 29% in the surgical group, with additional deaths from hemorrhage in non-surgical patients.
Conclusions:
- Pulmonary aspergillosis carries a high mortality rate in pediatric patients.
- Early surgical intervention is crucial for improving outcomes, particularly in cases with cavitating lesions unresponsive to antifungal therapy.
Introduction:
Aspergillosis is an invasive infection that affects mainly immunocompromised patients, and the lung is the most common site of infection. We reviewed our experience with the surgical management of pulmonary aspergillosis (PA) in pediatric population at a tertiary care institution.
Methods:
A retrospective chart review was conducted for pediatric patients (<16 years) who were managed for PA over the period from January 2001 to December 2016. Demographic, clinical, and outcome data were retrieved, and descriptive data were generated.
Results:
Eighty patients had microbiologically-proven PA over the period of the study, and 38 of them (48%) had a surgical intervention during their management. Among the surgical group, there were 19 males and 19 females with a mean age of 9.4 years (0.5-16). Thirty-five patients (92%) were in an immunocompromised state (10 of them have had bone marrow transplant), 2 patients had cystic lung disease, and 1 had scleroderma. All had fever and respiratory symptoms at presentation and received systemic antifungal medications. All had Computerized tomography (CT) scan examinations which showed features suggestive of the disease. Surgical procedures included lung biopsy in 13 patients (34%), segmentectomy in 12 patients (32%), lobectomy in 8 patients (21%), debridement/cavernostomy in 3 patients (8%), and 2 patients had pneumonectomy (5%). Histopathological examination revealed invasive fungal infection in 20 patients (53%) and aspergilloma in 18 (47%). Eleven patients (29%) died owing to a combination of fungal infection and the underlying disease. Three other patients, not included in the surgical series, died secondary to severe pulmonary hemorrhage while waiting for surgery. All had cavitation on CT scan near the hilum of the lung.
Conclusions:
Pulmonary aspergillosis is a severe invasive infection with a significant mortality. Early surgical intervention is recommended in patients who do not improve on antifungal medication, especially in those with cavitating lesions, in order to improve outcome.
Type Of Study:
Case series.
Level Of Evidence:
IV.
Related Concept Videos
01:27Pulmonary Embolism III: Nursing Management
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:25Urinary Tract Calculi VI: Surgical Management
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease