Document 0497
 DOCN  M9490497
 TI    Thoracotomy for pulmonary mycoses in non-HIV-immunosuppressed patients.
 DT    9411
 AU    Temeck BK; Venzon DJ; Moskaluk CA; Pass HI; Surgical Pathology
       Department, National Cancer Institute,; National Institutes of Health,
       Bethesda, MD 20892.
 SO    Ann Thorac Surg. 1994 Aug;58(2):333-8. Unique Identifier : AIDSLINE
       MED/94346902
 AB    Pulmonary mycoses can be life threatening in patients who are in an
       immunocompromised state stemming from defective host defenses or the use
       of certain treatment regimens. In 36 immunosuppressed patients
       undergoing thoracotomy for the treatment of pulmonary fungal disease,
       the underlying cause of immunosuppression was malignancy (n = 9),
       Wegener's granulomatosis (n = 4), hematologic disorders (aplastic
       anemia, 5-Q minus syndrome, or myelofibrosis) (n = 6), or chronic
       granulomatous disease of childhood (n = 17). The mean age of the
       patients was 25 years, and 89% were symptomatic (fever, n = 27; cough, n
       = 20; chest pain, n = 14; and other, n = 13). Chest x-ray studies
       revealed the presence of cavitary disease (n = 7), a mass (n = 8),
       infiltrates (n = 20), or cavity and infiltrate (n = 1). A preoperative
       diagnosis was lacking in 23 of the 36 patients. Procedures included
       wedge biopsy (n = 13), segmentectomy with or without wedge or chest wall
       resection (n = 5), lobectomy with or without chest wall resection (n =
       16), wedge resection plus completion pneumonectomy (n = 1), and
       segmentectomy plus completion pneumonectomy (n = 1). Fungi identified
       included Aspergillus (n = 23), Zygomycetes (n = 4), Cryptococcus (n =
       3), and other (n = 6; 1 each), and specific antifungal treatment was
       instituted in 34 of the patients (94%). The 31% operative (ie, < 30-day
       or inhospital) mortality was chiefly due to multiorgan system failure
       (9/11).(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Adolescence  Adult  Aspergillosis/IMMUNOLOGY/MORTALITY/SURGERY  Child
       Child, Preschool  Female  Human  *HIV Seronegativity  *Immunocompromised
       Host  Lung Diseases, Fungal/IMMUNOLOGY/MORTALITY/*SURGERY  Male  Middle
       Age  Postoperative Complications/MORTALITY  Prognosis  Risk Factors
       *Thoracotomy  JOURNAL ARTICLE

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