clove and Pulmonary-Aspergillosis

This retrospective study was designed to study the clinical profile, post-operative outcome with analysis of severity factors of pulmonary aspergilloma operated in our institute.. During a 5-year period (June 2009 to June 2014), 34 patients underwent surgery for pulmonary aspergilloma and were admitted in the surgical intensive care unit of the CHU/JRA Antananarivo.. The group consist of 23 male patients and 11 female patients with a mean age of 42 ± 9.9 years. In 29.4% of cases, it was a complex aspergilloma. The procedures performed were segmental resection (n = 3), lobectomy (n = 21), bi-lobectomy (n = 2), pneumonectomy (n = 7) and cavernostomy (n = 1). Median hospital stay was 4.5 ± 3 days. The postoperative lethality rate was 14.7% caused by respiratory failure, infection and underlying diseases. Main complications included bleeding, respiratory failures, and pulmonary infection.. Factors associated to increased postoperative complications included: the ASA score, decreased preoperative lung function, urgent procedures, smoking, postoperative mechanical ventilation, bleeding, hyperleukocytosis and surgery duration.

Topics: Adult; Critical Care; Female; Hospitals; Humans; Lung; Madagascar; Male; Middle Aged; Pulmonary Aspergillosis; Retrospective Studies; Treatment Outcome

We report a rare case of a huge aspergilloma developed within a bronchiectasis due to pulling by a pulmonary fibrosis of systemic scleroderma. The patient is a 58-year-old woman presenting a deterioration of the general state associated with repeating hemoptysis, dyspnea, dysphagia, sclérodactylia, generalized cutaneous sclerosis and Raynaud's phenomenon. There was no antecedent pulmonary tuberculosis. The patient had a pulmonary arterial hypertension complicated by a chronic pulmonary heart at the stage of right cardiac decompensation. Aspergillosis serology was positive and the immunological assessment confirmed scleroderma. The computed tomography showed a huge oblong opacity in a small round bell shape ("signe du grelot", Monad's sign) in the left upper lobe developed within a bronchiectasis, and a bilateral pulmonary fibrosis. Although surgery remains the recommended treatment of an aspergilloma, the management of our patient was medical in front of contra-indication for surgery. The evolution was marked by repeating hemoptysis and stability of the pulmonary lesions 2 years later. The management of this entity remains difficult and complicated; the prognosis is in general unfavourable and depends at the same time on the evolution of scleroderma and the aspergilloma infection.

Topics: Aspergillus; Female; Humans; Immunocompetence; Madagascar; Middle Aged; Mycetoma; Pulmonary Aspergillosis; Pulmonary Fibrosis; Scleroderma, Systemic; Tomography Scanners, X-Ray Computed

Topics: Adult; Female; Humans; Madagascar; Male; Prospective Studies; Pulmonary Aspergillosis