PT  - JOURNAL ARTICLE
AU  - Rosana Blavia
AU  - Antonia Flor
AU  - Isabel Serra
AU  - Montse Morta
AU  - Dolores Estivill
AU  - Ramon Trullas
AU  - Damian Perich
AU  - Esperanza Martin
AU  - Conxa Perez
AU  - Emilio Marquilles
TI  - Invasive pulmonary aspergillosis in patients with severe COPD. Compative study between probable invasive infection and colonization
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p3025
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p3025.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p3025.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - This retrospective study included patients with chronic respiratory disease with aspergillus isolation in respiratory cultures from Jan-07 to Dec-09. The diagnosis of probable invasive pulmonary aspergillus (IPA) was based on compatible clinical setting and HRCT findings. A univariate comparative analysis between IPA probable and aspergillar colonization was carried out.Results: Of the 103 patients registered 66 patients were excluded. Of the remaining 37 we diagnosed 15 patients (14%) with IPA probable and 22 (21%) as colonization. COPD in 73% of patients (80% GOLD III-IV). The prior use of corticosteroids was higher in IPA, with a greater accumulate mean 405 mgr in IPA v 74 mgr in colonizated (p<0.05). A greater number of hospital admissions were detected in IPA. The mean length of hospital stay was higher in IPA with 35±28 days as opposed to 13±22 d. in colonization (p:0.003) and respiratory failure (80% IPA v 36% p:0.009). Antifungal therapy was received by 91% of IPA and by 36% of colonized. The overall mortality rate was 47% in IPA and 23% in colonization.Conclusions: 1. Immunosupression by corticosteroids in COPD patients Gold III-IV is the major risk factor for invasive aspergillosis.2. The absence of clinical improvement in correctly treated exacerbations of severe COPD and recurrent isolation of aspergillus in sputum should point to the possibility of the existence of IPA and demand a HRCT scan.3. HRCT findings can detect early IPA in the shape of bronchial spread once bacterial or mycobacterial infections have been ruled out.