Management of patients with a single Aspergillus lung nodule

Management of patients with a single Aspergillus lung nodule

Aspergillus nodules are pulmonary nodules that have been confirmed by biospy to be due to Aspergillus. They are typically diagnosed after biopsy or resection for suspected lung cancer. Our approach to Aspergillus nodules is based on our clinical experience; clinical judgement is advised, and referral to specialists is recommended for complex patients. This algorithm does not apply to patients with multiple nodules; nodules that have not been biopsied should not be assumed to be Aspergillus nodules.

CT: computed tomography.

* Low-dose corticosteroid therapy is typically defined as < equivalent of prednisone 0.3 mg/kg/day. Prolonged high-dose corticosteroids are defined as dosages higher than low-dose therapy taken for >3 weeks.

¶ Antifungal options are outlined in UpToDate content.

Δ For patients at high risk for antifungal-related toxicity, treatment is sometimes deferred with close follow-up.

◊ Enlargement of a nodule while on antifungal therapy should prompt consideration of additional diagnoses (eg, antifungal resistance, chronic cavitary pulmonary aspergillosis, malignancy, mycobacterial infection). Tissue sampling allows detection of most of these diagnoses. Tissue samples should undergo histopathologic examination as well as fungal, mycobacterial, and bacterial cultures with susceptibility testing.

Graphic 142610 Version 1.0

خرید پکیج

Management of patients with a single Aspergillus lung nodule