ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở BỆNH NHÂN NẤM PHỔI ASPERGILLUS XÂM LẤN TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objective: To describe the clinical and paraclinical characteristics of patients with invasive pulmonary aspergillosis (IPA).

Subjects and Methods: A cross-sectional descriptive study was conducted on 52 patients diagnosed with 'proven' and 'probable' invasive pulmonary Aspergillosis, according to the 2021 diagnostic criteria of the Ministry of Health. The study took place at the Respiratory Center of Bach Mai Hospital from September 2024 to April 2025.

Results: The mean age of the study group was 69.17 ± 13.1 years, with a male predominance (80.8%). Chronic Obstructive Pulmonary Disease (COPD) was the most common underlying condition, accounting for 69.2% of cases. Clinical symptoms were often non-specific, with productive cough and dyspnea being the most frequent (90.4%). Microbiologically, respiratory specimen cultures were positive in 96.2% of cases, with Aspergillus fumigatus being the predominant species (88.5%), followed by Aspergillus flavus (7.7%). Lesions on chest computed tomography (CT) scans were mainly consolidation (53.85%) and nodules (40.38%). The halo sign, indicating a new pulmonary lesion, was present in 19.23% of patients.

Conclusion: Based on the study of 52 patients with invasive pulmonary aspergillosis at the Respiratory Center, we conclude that: The main at-risk population consists of elderly male patients (mean age 69.17) with COPD as the most common comorbidity (69.2%). Clinical symptoms are often non-specific and subtle, most commonly productive cough and dyspnea, which makes early diagnosis challenging. Microbiologically, Aspergillus fumigatus is the leading causative agent (88.5%), and respiratory specimen culture holds high diagnostic value. Chest CT findings are diverse, with consolidation and nodular lesions being the most prevalent. These characteristics highlight the need for a high index of suspicion for IPA in elderly patients with underlying COPD who are hospitalized for acute respiratory failure that does not respond to conventional antibiotics. Early sputum testing and culture should be performed if suspicious signs are present.