Surgery in broncho-pulmonary aspergillosis

Belcher, John; Plummer, Norman

doi:10.1016/s0007-0971(60)80067-8

Cited by 127 publications

(67 citation statements)

References 16 publications

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“…The radiological features of the peripheral lung shadows and the few available pathological studies (Hinson et al, 1952;Belcher and Plummer, 1960) do not exclude the possibility that most, if not all, of these are due simply to areas of nonspecific collapse. The bronchiectasis that develops is peculiarly characteristic; that a bronchial Arthus-type reaction contributes to its pathogenesis remains an intriguing possibility, although bronchial dilatation may follow prolonged occlusion from many causes, and peripheral saccular bronchiectasis related to bronchial plugging is found in other cases of severe asthma (Leopold, 1961).…”

Section: Course Of Diseasementioning

confidence: 99%

Allergic aspergillosis: review of 32 cases

Henderson¹

1968

Thorax

139

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Section: Course Of Diseasementioning

confidence: 99%

Allergic aspergillosis: review of 32 cases

Henderson¹

1968

Thorax

139

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“…Seventeen percent of the patients were categorised as having simple aspergilloma on CT and the remaining as complex aspergilloma according to criteria by Belcher and Plummer. [15] Most patients (89.9%) had involvement of a single lobe, and the majority (98.3%) had involvement of the upper lobes of either lung, with approximately equal involvement of the left upper (50.9%) and right upper lobes (47.5%) ( Table 1). Eleven patients reported ongoing respiratory symptoms 90 days after the multidisciplinary discussion.…”

Section: Resultsmentioning

confidence: 99%

“…It has the benefits of prevention of lifethreatening haemoptysis, eradication of the pyogenic component and probable prolongation of life. [15][16][17][18][19][20][21] Although surgical resection is considered curative, it is not possible in every patient, for a variety of physiological and technical reasons. Such reasons may include poor physical condition, severe comorbidity, poor pulmonary reserve, extensive lung involvement or inability to localise the bleeding site.…”

mentioning

confidence: 99%

Outcomes of resectable pulmonary aspergilloma and the performance gap in a high tuberculosis prevalence setting: A retrospective study

et al. 2017

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Background. Pulmonary aspergillomas develop in patients with underlying structural lung diseases. The mainstay of therapy is surgery. Objectives. To assess treatment and clinical outcomes following diagnosis of potentially resectable pulmonary aspergilloma at the Tygerberg Hospital (TBH) between January 2013 and December 2015.Methods. This was a retrospective analysis conducted at TBH. Patients were followed up between 6 and 29 months following diagnosis to analyse outcomes. Results. Fifty-nine patients presented for surgery. The mean (SD) age was 44.5 (8.8) years. Thirty-six (61.0%) were male and 13 (22.0%) were HIV-positive. A previous history of pulmonary TB was identified in 83.1% of the patients. One or both upper lobes were involved in 58 patients (98.3%) and haemoptysis was the most frequent symptom, occurring in 56 patients (94.9%). Nine patients (15.3%) were considered unfit for surgery. As of June 2016, 23 (46.0%) of the remaining 50 patients had undergone surgery and 3 (6.0%) had died before surgery was performed. The median time from multidisciplinary discussion to surgery was 190 days (interquartile range 134 -351). Twenty patients (87.0%) underwent lobectomy and 3 (13.0%) had pneumonectomy. There was no postoperative mortality. One patient developed bleeding, persistent air leak and aspiration pneumonia postoperatively. Three patients were hospitalised for >7 days postoperatively. Following surgery, only two patients reported ongoing respiratory symptoms by day 90. Conclusion. Less than half of the patients accepted for lung resection at TBH underwent surgery. Waiting times were long (>1 year in 25%) and were associated with mortality. Barriers to prompt surgery are complex, but should be addressed urgently.

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“…It may develop as a post-operative complication following resection of lung tissue (Monod, Dieudonne, and Tardieu, 1964). Five cases of pleural aspergillosis after surgical resection of tuberculous lung tissue have been reported by Belcher and Plummer (1960), Golebiowski (1958), and Sitkowski, Piotrowski, and Kryszkiewicz (1959. Sochocky (1959) has described aspergillosis of the pleura in two cases after resection of lung cancer, and Barlow (1954) (1964).…”

Section: Discussionmentioning

confidence: 99%

Infection of the pleura by Aspergillus fumigatus

Krakówka¹,

Rowińska²,

Halweg³

1970

Thorax

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Pleural aspergillosis occurs mostly in established cases of pleural empyema with a broncho-pleural fistula. Ten such patients are reported here: in all, Aspergillus fumigatus infection was related to tuberculosis. In three cases with an active, sputum-positive tuberculous process the pleural empyema was a complication of spontaneous pneumothorax in two, and of lung resection in one. In two cases the empyema occurred as a complication of tuberculous pleuritis, but A. fumigatus infection was noted only after the sputum had become negative for tubercle bacilli. In five patients with inactive tuberculosis, the empyema was a late com;plication of pneumothorax therapy. found in the sputum. A catheter was inserted into the pleural cavity, and Gram-negative bacilli sensitive to chloramphenicol were recovered from the pleural fluid. The patient was given a course of streptomycin, isoniazid, penicillin, and chloramphenicol therapy. In spite of this he deteriorated and after two months died of circulatory and respiratory failure. At necropsy both the adhesions and the pleura were covered by greenish fibrous masses which showed Aspergillus fumigatus on microscopical examination. In the apical posterior part of the visceral pleura an opening communication with the parenchymal lung cavity was found. Multiple tuberculous cavities were seen in both lungs.In this case the empyema resulted from perforation of the tuberculous cavity into the pleura. Secondary aspergillous infection of the empyema was not recognized during lifetime.

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Surgery in broncho-pulmonary aspergillosis

Cited by 127 publications

References 16 publications

Allergic aspergillosis: review of 32 cases

Allergic aspergillosis: review of 32 cases

Outcomes of resectable pulmonary aspergilloma and the performance gap in a high tuberculosis prevalence setting: A retrospective study

Infection of the pleura by Aspergillus fumigatus

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