Abstract
Pseudomembranous Aspergillus tracheobronchitis (PMATB) is a relatively uncommon form of invasive pulmonary aspergillosis.
PMATB is characterized by necrosis and sloughing of the respiratory epithelium resulting
from the invasion of the tracheobronchial mucosa by Aspergillus species. The prognosis for patients with PMATB and underlying immune compromise is
poor, but existing data suggest that the outcome of PMATB occurring in patients without
overt immune compromise is favorable. To investigate the clinical features and prognosis
for immunocompetent patients with PMATB in the study center, 10 patients with histologically
and microbiologically confirmed PMATB lacking overt immune compromise over a 9-year
period were retrospectively identified. Although all patients ultimately received
systemic antifungal therapy, 4 patients required mechanical ventilation and 3 patients
died. This report indicates that PMATB occurring in immunocompetent patients may exhibit
an aggressive course, with rapid progression of lung parenchymal involvement and a
fatal outcome.
Key Indexing Terms
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of the Medical SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Ulcerative and plaque-like tracheobronchitis due to infection with Aspergillus in patients with AIDS.Clin Infect Dis. 1993; 17: 344-352
- The invasive and saprophytic syndromes due to Aspergillus spp.Med Mycol. 2005; 43: S207-S238
- Pseudomembranous necrotizing tracheobronchitis caused by Aspergillus spp—contribution of one case with acute myeloid leukemia.Folia Med (Plovdiv). 2006; 48: 93-97
- Unilateral wheeze caused by pseudomembranous Aspergillus tracheobronchitis in the immunocompromised patient.Thorax. 1993; 48: 1285-1287
- Ulcerative and pseudomembranous Aspergillus tracheobronchitis in a patient with acute myeloid leukemia.Int J Hematol. 2009; 89: 257-258
- Pseudomembranous Aspergillus tracheobronchitis in a heart transplant recipient.Transpl Infect Dis. 2010; 12: 60-63
- Pseudomembranous tracheobronchitis caused by Aspergillus in a patient after peripheral blood stem cell transplantation.Ann Acad Med Singapore. 2000; 29: 531-533
- Ulcerative tracheobronchitis after lung transplantation. A new form of invasive aspergillosis.Am Rev Respir Dis. 1991; 144: 552-556
- Pseudomembranous tracheobronchitis caused by Aspergillus.Am Rev Respir Dis. 1991; 143: 1408-1411
- Nodular invasive tracheobronchitis due to Aspergillus in a patient with systemic lupus erythematosus.Lupus. 2002; 11: 325-328
- Pseudomembranous invasive tracheobronchial aspergillosis.Thorax. 2004; 59: 452
- Isolated invasive Aspergillus tracheobronchitis: a clinical study of 19 cases.Clin Microbiol Infect. 2010; 16: 689-695
- Successful treatment of post-influenza pseudomembranous necrotising bronchial aspergillosis with liposomal amphotericin, inhaled amphotericin B, gamma interferon and GM-CSF.Thorax. 1999; 54: 1047-1049
- Invasive tracheobronchial aspergillosis in an immunocompetent person.Am J Med Sci. 2005; 329: 107-109
- Commentary: unusual manifestations of aspergillosis.Thorax. 1995; 50: 812-813
- Endobronchial fungal disease: an under-recognized entity.Respiration. 2007; 74: 88-104
- Aspergillosis: the spectrum of the disease of 98 patients.Medicine (Baltimore). 1970; 49: 147-173
- Pseudomembranous tracheobronchitis caused by Aspergillus in immunocompromised patients.Scand J Infect Dis. 2005; 37: 937-942
- Dissection of a circulating and intrahepatic CD4(+)Foxp3(+) T-cell subpopulation in chronic hepatitis B virus (HBV) infection: a highly informative strategy for distinguishing chronic HBV infection states.J Infect Dis. 2012; 205: 1111-1120
- Serum galactomannan strongly correlates with outcome of invasive aspergillosis in acute leukaemia patients.Mycoses. 2011; 54: 523-530
- Diagnostic value of the serum galactomannan assay for invasive aspergillosis: it is less useful in non-haematological patients.Scand J Infect Dis. 2012; 44: 600-604
- Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease: a case control study from China.Clin Microbiol Infect. 2012; 18: 403-408
- Significance of isolation of Aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis.Results from a three-year prospective study. Am J Med. 1986; 81: 249-254
- A prospective survey of Aspergillus spp.in respiratory tract samples: prevalence, clinical impact and antifungal susceptibility. Eur J Clin Microbiol Infect Dis. 2011; 30: 1355-1363
- Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America.Clin Infect Dis. 2008; 46: 327-360
- Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study.Transplantation. 2006; 81: 320-326
- Combination antifungal treatment of pseudomembranous tracheobronchial invasive aspergillosis: a case report.Intensive Care Med. 2009; 35: 1641-1643
- Pseudomembranous and obstructive Aspergillus tracheobronchitis—optimal diagnostic strategy and outcome.Mycoses. 2006; 49: 37-42
Article info
Publication history
Accepted:
October 10,
2012
Received:
June 21,
2012
Footnotes
Disclosure: The authors have no financial or other conflicts of interest to disclose.
Identification
Copyright
© 2013 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
