Journal Article

Residual Pulmonary Abnormalities in Adult Patients with Chronic Paracoccidioidomycosis: Prolonged Follow-Up after Itraconazole Therapy

A. M. Tobón, C. A. Agudelo, M. L. Osorio, D. L. Alvarez, M. Arango, L. E. Cano and A. Restrepo

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 7, pages 898-904
Published in print October 2003 | ISSN: 1058-4838
Published online October 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/377538
Residual Pulmonary Abnormalities in Adult Patients with Chronic Paracoccidioidomycosis: Prolonged Follow-Up after Itraconazole Therapy

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Itraconazole effectively controls active paracoccidioidomycosis but appears not to hinder lung fibrosis. Clinical records and chest radiographs from 47 itraconazole-treated patients with prolonged posttherapy follow-up (mean follow-up period, 5.6 years) were analyzed; the radiographs were interpreted following pneumoconiosis standards that consider the lungs as 6 fields and grade damage according to the number of fields involved. Infiltrative lesions were observed at diagnosis in 93.6% of the patients. Fibrosis was observed in 31.8% of the patients at diagnosis and had not cleared at the end of the observation period in any of these patients. Fibrosis also developed de novo in 11 patients (25%), so that by the end of the follow-up period it was seen in 53.2% of patients overall. Fibrosis correlated with severity of infiltrates at diagnosis: fibrosis was present in 83% of patients with very severe infiltration and in 12.5% of patients with minor infiltration. Among patients with severe infiltration, fibrosis was present in 30%; this increased (to 75%) when bullae were concomitantly present at diagnosis. Prompt initiation of treatment is necessary to avoid the development of fibrosis.

Journal Article.  3666 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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