JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
J. L. Michaud
Willard A. Fry
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Baron, O.
Right arrow Articles by Fry, W. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Baron, O.
Right arrow Articles by Fry, W. A.

J Thorac Cardiovasc Surg 1998;115:63-69
© 1998 Mosby, Inc.

GENERAL THORACIC SURGERY

Aggressive surgical management in localized pulmonary mycotic and nonmycotic infections for neutropenic patients with acute leukemia: Report of eighteen cases

O. Baron, MDa, B. Guillaumé, MDb, P. Moreau, MDc, P. Germaud, MDb, P. Despins, MDa, A. Y. De Lajartre, MDd, J. L. Michaud, MDa, Sponsor: , Willard A. Fry, MD

Read at the Seventy-seventh Annual Meeting of The American Association for Thoracic Surgery, Washington, D.C., May 4-7, 1997.

Received for publication May 7, 1997; revisions requested June 2, 1997; revisions received August 1, 1997; accepted for publication August 4, 1997. Address for reprints: J. L. Michaud, MD, Department of Cardiothoracic Surgery, Hôpital Guillaume et René Laënnec, BP 1005, 44035 Nantes, France.

Objective: To prevent hemoptysis and relapse during subsequent chemotherapy-induced neutropenia in patients with localized forms of invasive pulmonary aspergillosis, we adopted an aggressive surgical approach.
Methods: From 1988 to 1996, 18 patients with hematologic diseases were referred with the diagnosis of localized invasive pulmonary aspergillosis. The diagnosis was based on clinical features, failure to respond to antibiotic therapy, an air crescent sign suggestive of aspergillosis on the computed tomographic scan (39%), and retrieval of fungi by bronchoalveolar lavage (44%).
Results: The following procedures were done: one pneumonectomy, four bilobectomies, seven lobectomies, six wedge resections, and one lobectomy with wedge resection (one patient had two procedures). No perioperative deaths or complications occurred. The histologic examination confirmed the diagnosis of invasive pulmonary aspergillosis in 12 patients. The six other diagnoses were as follows: one case of classic aspergilloma, one case of pneumonia, and four cases of pulmonary abscess. According to univariate analysis, thoracic pain was less common in the group with noninvasive pulmonary aspergillosis (1/6) than in the group with invasive pulmonary aspergillosis (8/12) (p < 0.05). Sixteen patients required subsequent hematologic treatments. Sixty-six percent of the patients are alive with a mean follow-up of 29.1 ± 27.8 months (range 2 to 103 months), with no statistically significant difference between the invasive and the noninvasive pulmonary aspergillosis groups. Five patients died of a recurrence of their malignant disease at a mean of 17.2 ± 12.5 months (range 2 to 30 months), and one had a cerebral recurrence of Aspergillus infection during a bone marrow transplantation 3 months later.
Conclusion: Aggressive surgical management radically improves the prognosis of invasive pulmonary aspergillosis, even if the surgical indications include some nonmycotic infections because of the difficulty in establishing the clinical diagnosis.




This article has been cited by other articles:


Home page
 ICVTSHome page
B. C. Danner, V. Didilis, H. Dorge, D. Mikroulis, G. Bougioukas, and F. A. Schondube
Surgical treatment of pulmonary aspergillosis/mycosis in immunocompromised patients
Interactive CardioVascular and Thoracic Surgery, October 1, 2008; 7(5): 771 - 776.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
P. Bulpa, A. Dive, and Y. Sibille
Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease
Eur. Respir. J., October 1, 2007; 30(4): 782 - 800.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
O.S. Zmeili and A.O. Soubani
Pulmonary aspergillosis: a clinical update
QJM, June 1, 2007; 100(6): 317 - 334.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Oki, H. Saka, C. Sako, S. Tanaka, Y. Kawata, C. Kitagawa, and N. Minemura
Cavitating invasive pulmonary aspergillosis visualized and diagnosed by ultrathin bronchoscopy.
Chest, February 1, 2006; 129(2): 475 - 479.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. Matt, F. Bernet, J. Habicht, F. Gambazzi, A. Gratwohl, H.-R. Zerkowski, and M. Tamm
Predicting Outcome After Lung Resection for Invasive Pulmonary Aspergillosis in Patients With Neutropenia
Chest, December 1, 2004; 126(6): 1783 - 1788.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Microbiol.Home page
A. Azzola, J. R. Passweg, J. M. Habicht, L. Bubendorf, M. Tamm, A. Gratwohl, and G. Eich
Use of Lung Resection and Voriconazole for Successful Treatment of Invasive Pulmonary Aspergillus ustus Infection
J. Clin. Microbiol., October 1, 2004; 42(10): 4805 - 4808.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J.M. Habicht, M. Preiss, J. Passweg, P. Dalquen, P. Matt, H. Adler, R. Frei, and H.-R. Zerkowski
Invasive pulmonary aspergillosis: effects of early resection in a neutropenic rat model
Eur. J. Cardiothorac. Surg., November 1, 2002; 22(5): 728 - 732.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
K. Al-Kattan, M. Ashour, W. Hajjar, M. Salah El Din, M. Fouda, and A. Al Bakry
Surgery for pulmonary aspergilloma in post-tuberculous vs. immuno-compromised patients
Eur. J. Cardiothorac. Surg., October 1, 2001; 20(4): 728 - 733.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. Reichenberger, J.M. Habicht, A. Gratwohl, and M. Tamm
Diagnosis and treatment of invasive pulmonary aspergillosis in neutropenic patients
Eur. Respir. J., January 1, 2001; 19(4): 743 - 755.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
K. Meijer, W. E. de Graaff, S. M. G. J. Daenen, and J. van der Meer
Successful Treatment of Massive Hemoptysis in Acute Leukemia With Recombinant Factor VIIa
Arch Intern Med, July 24, 2000; 160(14): 2216 - 2217.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. M. Habicht, J. Passweg, T. Kuhne, K. Leibundgut, and H.-R. Zerkowski
SUCCESSFUL LOCAL EXCISION AND LONG-TERM SURVIVAL FOR INVASIVE PULMONARY ASPERGILLOSIS DURING NEUTROPENIA AFTER BONE MARROW TRANSPLANTATION
J. Thorac. Cardiovasc. Surg., June 1, 2000; 119(6): 1286 - 1287.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J.-F. Regnard, P. Icard, M. Nicolosi, L. Spagiarri, P. Magdeleinat, B. Jauffret, and P. Levasseur
Aspergilloma: a series of 89 surgical cases
Ann. Thorac. Surg., March 1, 2000; 69(3): 898 - 903.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. M. Habicht, F. Reichenberger, A. Gratwohl, H.-R. Zerkowski, and M. Tamm
Surgical aspects of resection for suspected invasive pulmonary fungal infection in neutropenic patients
Ann. Thorac. Surg., August 1, 1999; 68(2): 321 - 325.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1998 by The American Association for Thoracic Surgery.