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Chronic necrotizing pulmonary aspergillosis: pathologic outcome after itraconazole therapy
1Department of Medicine, Pulmonary Disease/Critical Care Service, Fitzsimons Army Medical Center, Aurora, Colorada, USA.
Objective:
To characterize chronic necrotizing pulmonary aspergillosis (CNPA) clinically, radio-graphically, and pathologically and to describe its response to treatment.
Material And Methods:
We present three cases of well-documented CNPA and detail the long-term clinical and pathologic responses to the new antifungal triazole, itraconazole.
Results:
Although all three patients had an appreciable clinical response to itraconazole therapy, tissue obtained at the time of operation or autopsy revealed residual CNPA despite 5 to 12 months of treatment. Even though pathologic resolution of the CNPA did not occur, patient prognosis was determined solely by comorbid illness.
Conclusion:
Itraconazole seems to be effective in CNPA when used in a suppressive (rather than curative) role in patients with limited life expectancy.