Chronic necrotizing pulmonary aspergillosis: pathologic outcome after itraconazole therapy.

Abstract

OBJECTIVE: To characterize chronic necrotizing pulmonary aspergillosis (CNPA) clinically, radio-graphically, and pathologically and to describe its response to treatment. MATERIAL AND METHODS: We present three cases of well-documented CNPA and detail the long-term clinical and pathologic responses to the new antifungal triazole, itraconazole. RESULTS: Although all three patients had an appreciable clinical response to itraconazole therapy, tissue obtained at the time of operation or autopsy revealed residual CNPA despite 5 to 12 months of treatment. Even though pathologic resolution of the CNPA did not occur, patient prognosis was determined solely by comorbid illness. CONCLUSION: Itraconazole seems to be effective in CNPA when used in a suppressive (rather than curative) role in patients with limited life expectancy.