Chronic necrotizing pulmonary aspergillosis: pathologic outcome after itraconazole therapy.

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.