Surgical treatment of pulmonary aspergillosis/mycosis in immunocompromised patients
Bernhard C. Danner 1*,
Vassilios Didilis 2,
Hilmar Dorge 1,
Dimitrios Mikroulis 2,
Georgios Bougioukas 2,
Friedrich A. Schondube 1
1 Georg August University of Gottingen, Germany
2 Democritus University of Thrace, Alexandroupolis, Greece
* To whom correspondence should be addressed. E-mail: drdanner{at}arcor.de.
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Abstract |
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Invasive pulmonary aspergillosis is a severe complication in immunosuppressed patients. Surgical resection can be curative in certain patients after antifungal treatment. Over a 7-year period, ten patients with suspected invasive pulmonary aspergillosis of two university hospitals were retrospectively reviewed. A literature review was undertaken. Patient's age was 48.1 years (mean); the cause of immunosuppression was a hematological disease with consecutive therapy in seven patients and chronically corticoid therapy in three patients. After an antifungal therapy, surgical resection was performed with lobectomy/segmentectomy in 60% and with wedge-resection in 40%. Postoperative course were uneventful in 7 patients, two patients died due to infectional circumstances, one patient was reoperated because of empyema. The underlying disease marked long-term follow up. Resection of focal pulmonary invasive aspergillosis can be curative. Clinical circumstances and dissemination must be taken into consideration to indicate surgery. To point out the best pathway randomized prospective studies are necessary. Keywords: Pulmonary aspergillosis; Thoracic surgery; Immunosuppression
