Abstract
Background: We have experienced a lot of chronic pulmonary aspergillosis (CPA) cases showing exacerbation associated with change of intracavitary air-fluid levels during the development process. It seems very possible that appearances and disappearances of air-fluid levels are related to exacerbation of CPA. But it has yet to be determined.
Aims and objectives: To demonstrate relationship between air-fluid levels and acute exacerbation of CPA.
Method: We analyzed retrospectively our patients with acute exacerbation of CPA during the period from 2001 to 2010 at Ibarakihigashi National Hospital.
Results: We experienced 93 cases of acute exacerbation of CPA and the incidence of appearance of air-fluid level was 34% (32 patients). At deterioration, new infiltrative shadows appeared on separate sites from primary cavities in 33 patients (35%), and 27 of them previously had air-fluid levels in their cavities. In 15 patients, fluid volume in their cavities increased before acute exacerbation. Eight of them showed new infiltrations away from primary lesions and fluid volume in their cavities decreased after acute exacerbation. Corticosteroids drastically improved their infiltrations on chest radiograph, blood findings and medical conditions in 5 out of 8. But in 3patients, corticosteroids didn't improve their conditions.
Conclusion: The air-fluid levels in cavities were associated with acute exacerbation of CPA. In some cases, patients showed new infiltrations away from cavities with decreased fluids during acute exacerbation. It suggested that fluids in cavities, which contained substances produced by Aspergillus, might damage separate sites from primary cavities.
- © 2011 ERS