Efficacy Of Itraconazole In Chronic Cavitary Pulmonary Aspergillosis

A RANDOMIZED CONTROLLED STUDY OF ITRACONAZOLE IN CHRONIC CAVITARY PULMONARY ASPERGILLOSIS

The purpose of this study is to determine whether there itraconazole is effective in the treatment of chronic cavitary pulmonary aspergillosis

The role of itraconazole is still not clear in the treatment of chronic cavitary pulmonary aspergillosis(CCPA). Some studies have shown a beneficial role of itraconazole in reducing hemoptysis. So the present study is aimed at analyzing the role of itraconazole in CCPA.

1. Inclusion Criteria:

   1. Clinical symptoms: -presence of chronic pulmonary/systemic symptoms lasting ≥ six weeks.

   2. Radiological findings:

      • Evidence of slowly progressive pulmonary lesions over weeks-months including cavities with surrounding inflammation.
      • presence of intracavitary mass with a surrounding crescent of air,and presence of pleural thickening in peripheral lesions.

   3. Microbiological/Immunological findings: Positive results in the aspergillus precipitin test, demonstration of aspergillus hyphae in sputum or BAL fluid or cultures of BAL/sputum growing aspergillus species.

2. The diagnosis of CCPA will be made if

   1. Patient satisfies at least 1, 2a or 2b and/ or any of the 3rd criteria.
   2. FNAC from the cavity wall will be considered in atypical cases

3. Exclusion Criteria:

   1. Invasive aspergillosis
   2. Allergic broncho-pulmonary aspergillosis (ABPA)
   3. Active tuberculosis or malignancy
   4. Pregnant females