Clinical manifestations and outcome analysis of invasive pulmonary aspergillosis infection: a retrospective study in 43 nonneutropenic patients

Abstract

Objective To investigate clinical characteristics of early-onset invasive pulmonary aspergillosis (IPA) in nonneutropenic patients. Methods Retrospective analysis was used to investigate clinical manifestations and auxiliary examination characteristics in 43 patients with IPA and 51 patients with community-acquired pneumonia in the early stage. Results Risk factors of IPA were dust and mold exposure, bronchiectasis, old pulmonary tuberculosis, and nasosinusitis. The incidence rate of complex clinical manifestations was 60.47% during the first week of IPA. The incidence rate of white blood cell (WBC) count >20.0 × 109/L was 51.16%. Lung CT findings indicated incidence rates of single or multiple nodules with a halo sign and central airway expansion with ground glass opacity were 27.9% and 37.21%, respectively. Mortality rates of patients with IPA given empirical and targeted antifungal treatments were 12.0% and 42.9%, respectively. Conclusions Bronchiectasis, old pulmonary tuberculosis, nasosinusitis, and dust and mold exposure may increase the risk of IPA. Single or multiple nodules with a halo sign and central airway expansion with ground glass opacity may be early-stage lung CT findings in patients with IPA. A WBC count >20.0 × 109/L may aid in early diagnosis, and empirical antifungal therapy may reduce mortality in patients with IPA.