ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG NẤM PHỔI ASPERGILLUS XÂM LẤN Ở BỆNH NHÂN BỆNH PHỔI TẮC NGHẼN MẠN TÍNH

Abstract

Objective: To decribe the clinical and subclinical of invasive pulmonary aspergillosis in patients with chronic obtructive pulmonary disease. Subject and method: retrospective descriptive research, progressive research in 58 patients with COPD diagnosed invasive pulmonary Aspergillosis (IPA) and treated in National Lung hospital from June 2022 to September 2024. 4 of 58 patients (6,9%) were proven diagnosis, 93.1% were probable diagnosis. Result: 100% is male, average age 68,76 ±9,378. Short of breath is the main reason to admit hospital. Co - morbidities: hypertension is predominant (44,8%), diabetes accounts for 31%. Clincal presentations: dyspnea (100%), productive cough (93,1%), fever (51,7%), chest pain (48,3%), hemoptysis (6,9%). Subclinical features: High CRP, average 102,2 ± 65,5; CT imaging finding: bilateral lesion 86,2%; nodule/multiple nodules (91,4%), ground – glass opacity 72,4%, consolidation 63,8%, halosign 39,7%. Culture: Aspergillus fumigatus accounts for 93%, combination with A. Flavus 3%, co – infection lung disease: fungi and bacteria 28/58 (48,3%), fungi and virus 6/58 (10,3%). Bronchoscopy: pseudofilm 15/39 (38,5%); Antifungal resistance: resistance to amphotericin B is 93,1%. Outcome: death 60,3%. Conclusion: Patients with COPD suffer from IPA has poor prognosis, high mortality rate so it is necessary to get early dignosis and suitable treatment.