000			03400na a2200313 4500
003			H12O
005			20210625062811.0
008			130622s2012 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_9263 _aFernández Ruiz, Mario _eMedicina Interna
100			_aGarcía Luján, Ricardo _91193 _eNeumología
100			_aLizasoaín Hernández, Manuel _9870 _eMedicina Interna
100			_9162 _aLópez Medrano, Francisco _eEnfermedades Infecciosas
100			_9876 _aAguado García, José María _eEnfermedades Infecciosas
100			_aSan Juan Garrido, Rafael _9869 _eMedicina Interna
245	0	0	_aAspergillus tracheobronchitis report of 8 cases and review of the literature _h[artículo]
260			_bMedicine, _c2012
300			_a91(5):261-273.
500			_aFormato Vancouver: Fernández-Ruiz M, Silva JT, San-Juan R, de Dios B, García-Luján R, López-Medrano F, et al. Aspergillus tracheobronchitis: report of 8 cases and review of the literature. Medicine (Baltimore). 2012;91(5):261-73.
501			_aPMID: 22932790
504			_aContiene 76 referencias
520			_aAspergillus tracheobronchitis (AT) is an infrequent but severe form of invasive pulmonary aspergillosis in which the fungal infection is entirely or predominantly confined to the tracheobronchial tree. We reviewed 8 cases of AT diagnosed in our tertiary care center during an 18-year period, as well as 148 cases previously reported in the English literature from 1985 to July 2011. The demographic, clinical, imaging, bronchoscopic, and outcome characteristics of every eligible patient were excerpted, and predictors of inhospital mortality were identified by logistic regression. Solid organ transplantation (SOT) (44.2%), hematologic malignancy (21.2%), neutropenia (18.7%), and chronic obstructive pulmonary disease (15.4%) were the most common underlying conditions reported. Most cases occurred in patients receiving long-term corticosteroid treatment (71.8%) or chemotherapy (25.0%). Fever and respiratory complaints (cough, dyspnea, stridor, or wheezing) were the most frequent symptoms; one-third of patients developed acute respiratory distress at presentation, and 15.1% were asymptomatic at the time of diagnosis. Initial imaging studies were not informative in 47.4% of the cases. Aspergillus fumigatus was the predominant species (74.4%). The pseudomembranous form was the most commonly observed (31.9% of cases) and was more frequent in neutropenic patients (p = 0.007), whereas ulcerative AT (31.2%) was associated with SOT (p = 0.001). The most frequent antifungal monotherapy regimens were amphotericin B deoxycholate (23.1%) and itraconazole (18.6%), whereas combined therapy was administered in 35.9% of the cases. Overall inhospital mortality was 39.1%, with neutropenia (odds ratio [OR], 20.47; p < 0.001) and acute respiratory distress at presentation (OR, 9.54; p = 0.002) as independent prognostic factors. Our pooled analysis of the literature shows that AT remains a rare opportunistic infection with a nonspecific presentation and a variable course depending on the nature of the predisposing factor.
710			_96 _aServicio de Medicina Interna
710			_988 _aServicio de Neumología
710			_9625 _aInstituto de Investigación imas12
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/1/pc10278.pdf _ySolicitar documento
942			_n0 _2ddc _cART
999			_c10278 _d10278