Nagai H
Department of Pulmonary Diseases, Tokyo National Chest Hospital, Japan.
Kekkaku. 1997 Feb;72(2):99-107.
The characteristics of chest x-ray films in 19 patients with saprophytic pulmonary aspergillosis secondary to acid-fast bacilli infection were reported. The saprophytic form, exemplified by the classic fungus ball or mycetoma, results from the growth of fungal mycelia within a pre-existing area of destroyed lung, typically a pre-existing cavity such as that resulting from tuberculosis. Aspergillus fumigatus was detected in 52.6% of sputum cultures from 19 patients. Aspergillus precipitin test was positive in 68.4% of patients. Thickening of cavitary walls was first found in 85% of chest x-ray films. Eighty percent of patients had pulmonary aspergillosis within 3 years after cavitary lesions were stable. Invasive pulmonary aspergillosis (IPA) is characterized by hyphal invasion and destruction of pulmonary tissue. The risk of acquiring IPA correlates with the duration and degree of immunosuppression or neutropenia. IPA recently has been encountered in patients with human immunodeficiency virus (HIV) infection. The number of case reports on chronic necrotizing pulmonary aspergillosis is increasing, but it is supposed the clinical entity of this disease still has not been established.
报告了19例耐酸杆菌感染继发腐生性肺曲霉病患者的胸部X光片特征。腐生形式以典型的真菌球或曲菌球为代表，是真菌菌丝体在预先存在的肺组织破坏区域内生长的结果，通常是由结核病等导致的预先存在的空洞。在19例患者的痰培养中，52.6%检测到烟曲霉。68.4%的患者曲霉沉淀素试验呈阳性。85%的胸部X光片首先发现空洞壁增厚。80%的患者在空洞性病变稳定后3年内发生肺曲霉病。侵袭性肺曲霉病（IPA）的特征是菌丝侵袭和肺组织破坏。发生IPA的风险与免疫抑制或中性粒细胞减少的持续时间和程度相关。IPA最近在人类免疫缺陷病毒（HIV）感染患者中出现。关于慢性坏死性肺曲霉病的病例报告数量正在增加，但据推测该疾病的临床实体仍未确立。
