Articles Vol. 65 No. CĐ 3 - Bệnh viện Phổi Trung ương 15/05/2024

25. CLINICAL AND PARACLINICAL CHARACTERISTICS OF PATIENTS WITH CHRONIC PULMONARY ASPERGILLOSIS FUNGUS INFECTION UNDERGOING SURGERY AT NATIONAL LUNG HOSPITAL FROM 2020 TO 2022

Pham Van Doan1,2, Nguyen Thi Bich Ngoc1,2, Nguyen Thi Minh Nhat3,4
1 National Lung Hospital
2 Bệnh viện Phổi Trung ương
3 Hanoi Medical University
4 Đại học Y Hà Nội
Corresponding author: Dr.doanpham@gmail.com
DOI: 10.52163/yhc.v65iCD3.1121
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Keywords
Chronic Pulmonary Aspergillosis, CPA, surgery.
Abstract

Background: Chronic pulmonary aspergillosis (CPA) is a chronic lung disease caused by Aspergillus fungus, commonly found in tuberculosis patients with cavitary sequelae of tuberculosis. The prevalence of CPA in Vietnam is high. CPA treatment includes two main methods: Antifungal treatment and surgery. This study was conducted with the objectives of describing the clinical and paraclinical characteristics of a group of patients with CPA undergoing surgery at the National Lung Hospital.

Methods: Descriptive cross-sectional study. Subjects: Patients with CPA who underwent surgery at the National Lung Hospital from January 1, 2020 to December 31, 2022. Sampling method: Total population sampling. Information collecting method: Using medical records, processing data by SPSS software.

Results: There were 126 patients included and studied. The average age of patients diagnosed with CPA in this study was 53 ± 13. The most common reason for hospital admission was hemoptysis which was 82% of the cases. The most common clinical symptom was hemoptysis (83%). History of pulmonary tuberculosis accounted for 61.1% of cases. The most common lesions on diagnostic imaging results are: Cavities (73.6%), aspergilloma (66.4%), and bronchiectasis (25.6%). Vascular abnormalities accounted for 40%, including abnormalities of bronchial arteries, internal/mammary/intercostal arteries, pulmonary arteries and are related to hemoptysis levels of patients.

Conclusion: The group of CPA patients who underwent surgery at the National Lung Hospital often have a history of pulmonary tuberculosis, with hemoptysis as the main symptom, which was also the reason for hospital visit. The most common lesions on diagnostic imaging results were cavities accompanied by aspergilloma or intra-cavitary abnormalities, and bronchiectasis. Vascular abnormalities were encountered in 40% of cases and related to the condition and severity of hemoptysis of the patients.

References
[1]
Duong TMN, Le MH, Beardsley J et al., Updated Google Scholar
[2]
estimation of the burden of fungal disease in Google Scholar
[3]
Vietnam. Mycoses. 2023;66(4):346–53. Google Scholar
[4]
Kosmidis C, Denning DW, The clinical spectrum Google Scholar
[5]
of pulmonary aspergillosis. Thorax. 2015 Mar;70(3):270–7. Google Scholar
[6]
Denning DW, Cadranel J, Beigelman-Aubry C et Google Scholar
[7]
al., Chronic pulmonary aspergillosis: Rationale Google Scholar
[8]
and clinical guidelines for diagnosis and management. Google Scholar
[9]
Eur Respir J. 2016 Jan;47(1):45–68. Google Scholar
[10]
Kasprzyk M, Pieczyński K, Mania K et al., Google Scholar
[11]
Surgical treatment for pulmonary aspergilloma Google Scholar
[12]
– early and long-term results. Kardiochir Torakochirurgia Google Scholar
[13]
Pol. 2017 Jun;14(2):99–103. Google Scholar
[14]
Smith NL, Denning DW, Underlying conditions in Google Scholar
[15]
chronic pulmonary aspergillosis including simple Google Scholar
[16]
aspergilloma. Eur Respir J. 2011 Apr;37(4):865–72. Google Scholar
[17]
Sezen CB, Aker C, Doğru MV et al., Factors affecting Google Scholar
[18]
survival after anatomical lung resection Google Scholar
[19]
in pulmonary aspergilloma: Our 10-year single Google Scholar
[20]
institution experience. Turk Gogus Kalp Damar Google Scholar
[21]
Cerrahisi Derg. 2022 Jan;30(1):92–100. Google Scholar
[22]
Horan-Saullo JL, Alexander BD, 38 - Opportunistic Google Scholar
[23]
Mycoses. In: Broaddus VC, Mason RJ, Google Scholar
[24]
Ernst JD, King TE, Lazarus SC, Murray JF, et Google Scholar
[25]
al., editors. Murray and Nadel’s Textbook of Google Scholar
[26]
Respiratory Medicine (Sixth Edition) [Internet]. Google Scholar
[27]
Philadelphia: W.B. Saunders; 2016 [cited 2024 Google Scholar
[28]
Apr 4]. p. 661-681.e16. Available from: Https:// Google Scholar
[29]
www.sciencedirect.com/science/article/pii/ Google Scholar
[30]
B9781455733835000385 Google Scholar