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Abstract:
During a 10-year-period, six patients with non-postoperative aspergillus infection of the pleura were seen. In all patients a pulmonary aspergillus infection had been present for some years. The fungus invaded the pleura, causing a bronchopleural fistula and a cavity in the pleural space. A prerequisite for the pleural aspergillosis was that the lung and pleura were previously damaged, usually by therapeutic pneumothorax for active tuberculosis some decades earlier. The fungus can cause destruction of the lung and death of the patient from the chronic infection unless treated. The best treatment is early excision of the pleura with resection of the upper lobe or if necessary the whole lung. To reduce the risk of postoperative aspergillus empyema, the patient should be treated with antifungal agents before and after operation. In inoperable patients, local antifungal treatment may clear the infection but is not always effective.
Insights
Non-postoperative pleural aspergillosis, a rare fungal infection, arises from pre-existing lung damage. Early surgical intervention and antifungal therapy are crucial for treating this severe condition.
Area of Science:
- Medicine
- Infectious Diseases
- Pulmonology
Background:
- Pleural aspergillosis is a rare but severe fungal infection.
- It often follows chronic pulmonary aspergillosis and pre-existing lung damage, such as from therapeutic pneumothorax for tuberculosis.
Purpose of the Study:
- To describe the clinical presentation, predisposing factors, and treatment outcomes of non-postoperative pleural aspergillosis.
Main Methods:
- Retrospective case series analysis of six patients diagnosed with non-postoperative pleural aspergillosis over a 10-year period.
- Review of patient histories, diagnostic findings, treatment strategies, and outcomes.
Main Results:
- All patients had a history of chronic pulmonary aspergillosis and damaged pleura/lung, often from prior tuberculosis treatment.
- Infection led to bronchopleural fistula and pleural cavity formation.
- Surgical resection (pleurectomy and lung resection) combined with antifungal agents showed the best outcomes.
Conclusions:
- Non-postoperative pleural aspergillosis requires prompt diagnosis and aggressive management.
- Surgical excision and antifungal therapy are essential for effective treatment.
- Preventing postoperative aspergillus empyema necessitates pre- and post-operative antifungal administration.