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Clinical features of aspergillus tracheobronchitis in two patients without immune compromise and literature review

  

  1. 1.Department of Respiratory Medicine,  the First hospital of QuanZhou Affiliated to
    Fujian Medical University,  QuanZhou 362000, China; 2.Department of Respiratory Diseases,
    The 960th Hospital of PLA, Taian  271000, China
  • Online:2019-06-20 Published:2019-08-02
  • Contact: Corresponding author:LI Baochun, Email:libaochun88@163.com

Abstract: Objective  To analyze the clinical features of aspergillus tracheobronchitis( ATB) in patients without immune compromise. Methods  A retrospective analysis was carried out on clinical data of 2 case of ATB patient without immune compromise who were admitted in 2018.Relevant literatures reported between 2000 and 2018 were reviewed. Results  Combined with the cases mentioned in this article,  there were altogether 14 cases without immune compromise diagnosed as ATB included into the analysis. Among them,  9 were male and 5 were female,  with their average age being 48±17 years old (2178 years old). The symptoms of fever,  dyspnea attacked most of the patients. Abnormal presentation of the tracheal wall or lumen were found more frequently than other signs in  abnormal pulmonary imaging(10/14,71.4%). Pseudomembranous lesions were the most frequent form observed by broncoscopy(11/14,78.6%). However,  there was no ulcer lesion showed by broncoscopy. All of the 14 cases have been misdiagnosed as pneumonia,  and failed to respond to antibiotic treatment. And among them,  11 cases were discharged with improvement while 3 cases died. Conclusion  Our pooled analysis shows that ATB,though remaining a rare infection,can be presented in patients without immunocompressed. Fever and dyspnoea resistant to corticosteroids and appropriate antibiotics with or without abnormal chest film should raise the suspicion of ATB in immunocompetent patients. Early diagnosis of ATB is based on bronchoscopic examination.

Key words: aspergillosis, , allergic bronchopulmonary, immunologic deficiency syndromes