Allergic bronchopulmonary aspergillosis misdiagnosed as smear negative pulmonary tuberculosis; a retrospective study from Pakistan

Iqbal, Nousheen; Sheikh, Muhammad Dawood Amir; Jabeen, Kauser; Awan, Safia; Irfan, Muhammad

doi:10.1016/j.amsu.2021.103045

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…In Pakistan, Iqbal et al. (2016) found nine (13%) of 69 patients with dual infection, but it was not clear at what point in their PTB treatment course CPA was diagnosed ( Iqbal et al., 2021 ). Likewise, in Iran, nine of 94 (10%) of patients had CPA during or immediately after ATT therapy ( Hedayati et al., 2015 ).…”

Section: Methodsmentioning

confidence: 99%

New estimation of the prevalence of chronic pulmonary aspergillosis (CPA) related to pulmonary TB – a revised burden for India

Denning

Cole²,

Goel³

2023

IJID Regions

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Section: Methodsmentioning

confidence: 99%

New estimation of the prevalence of chronic pulmonary aspergillosis (CPA) related to pulmonary TB – a revised burden for India

Denning

Cole²,

Goel³

2023

IJID Regions

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“…ABPA can also be misdiagnosed as TB. A retrospective study from Pakistan reported 71 patients with ABPA out of which 63 (88.7%) were being managed as a case of smear negative TB and had received empiric anti-TB therapy once ( n = 52, 82.5%), twice ( n = 8, 12.6%) or thrice ( n = 3, 4.7%) [ 76 ]. This finding was similar to that of a case report from Thailand in a 19-year-old with ABPA who had received anti-TB treatment twice [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

Pulmonary and Extrapulmonary Manifestations of Fungal Infections Misdiagnosed as Tuberculosis: The Need for Prompt Diagnosis and Management

Ekeng

Davies

Osaigbovo

et al. 2022

JoF

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Fungal infections commonly present with myriad symptoms that mimic other clinical entities, notable amongst which is tuberculosis. Besides histoplasmosis and chronic pulmonary aspergillosis, which can mimic TB, this review has identified several other fungal infections which also do. A total of 80 individual cases misdiagnosed as TB are highlighted: aspergillosis (n = 18, 22.5%), histoplasmosis (n = 16, 20%), blastomycosis (n = 14, 17.5%), cryptococcosis (n = 11, 13.8%), talaromycosis (n = 7, 8.8%), coccidioidomycosis (n = 5, 6.3%), mucormycosis (n = 4, 5%), sporotrichosis (n = 3, 3.8%), phaeohyphomycosis (n = 1, 1.3%) and chromoblastomycosis (n = 1, 1.3%). Case series from India and Pakistan reported over 100 cases of chronic and allergic bronchopulmonary aspergillosis had received anti-TB therapy before the correct diagnosis was made. Forty-five cases (56.3%) had favorable outcomes, and 25 (33.8%) died, outcome was unclear in the remainder. Seventeen (21.3%) cases were infected with human immunodeficiency virus (HIV). Diagnostic modalities were histopathology (n = 46, 57.5%), culture (n = 42, 52.5%), serology (n = 18, 22.5%), cytology (n = 2, 2.5%), gene sequencing (n = 5, 6.3%) and microscopy (n = 10, 12.5%) including Gram stain, India ink preparation, bone marrow smear and KOH mount. We conclude that the above fungal infections should always be considered or ruled out whenever a patient presents with symptoms suggestive of tuberculosis which is unconfirmed thereby reducing prolonged hospital stay and mortalities associated with a delayed or incorrect diagnosis of fungal infections.

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“…ABPA is characterized by inflammation in the lung due to hypersensitivity to the fungus Aspergillus sp. It is related to patients with asthma and cystic fibrosis, some patients with tuberculosis [ 56 ], or who suffer from chronic obstructive pulmonary disease (COPD) [ 57 ].…”

Section: Fungal Infectionsmentioning

confidence: 99%

“…The most common symptoms are chronic cough, wheezing, and recurrent pulmonary infiltrates, with a chest X-ray showing dilatation of the bronchi with phlegm (bronchiectasis). However, patients with ABPA may present nonspecific symptoms that are like other pre-existing pulmonary pathologies, reporting symptoms such as productive cough, wheezing, fever, chest pain, sweating, weight loss, blood expectoration (hemoptysis), and golden-brown mucus secretion is characteristic of this pathology [ 56 ].…”

Section: Fungal Infectionsmentioning

confidence: 99%

Nanotechnology-Based Approaches for Voriconazole Delivery Applied to Invasive Fungal Infections

et al. 2023

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Invasive fungal infections increase mortality and morbidity rates worldwide. The treatment of these infections is still limited due to the low bioavailability and toxicity, requiring therapeutic monitoring, especially in the most severe cases. Voriconazole is an azole widely used to treat invasive aspergillosis, other hyaline molds, many dematiaceous molds, Candida spp., including those resistant to fluconazole, and for infections caused by endemic mycoses, in addition to those that occur in the central nervous system. However, despite its broad activity, using voriconazole has limitations related to its non-linear pharmacokinetics, leading to supratherapeutic doses and increased toxicity according to individual polymorphisms during its metabolism. In this sense, nanotechnology-based drug delivery systems have successfully improved the physicochemical and biological aspects of different classes of drugs, including antifungals. In this review, we highlighted recent work that has applied nanotechnology to deliver voriconazole. These systems allowed increased permeation and deposition of voriconazole in target tissues from a controlled and sustained release in different routes of administration such as ocular, pulmonary, oral, topical, and parenteral. Thus, nanotechnology application aiming to delivery voriconazole becomes a more effective and safer therapeutic alternative in the treatment of fungal infections.

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Allergic bronchopulmonary aspergillosis misdiagnosed as smear negative pulmonary tuberculosis; a retrospective study from Pakistan

Cited by 9 publications

References 21 publications

New estimation of the prevalence of chronic pulmonary aspergillosis (CPA) related to pulmonary TB – a revised burden for India

New estimation of the prevalence of chronic pulmonary aspergillosis (CPA) related to pulmonary TB – a revised burden for India

Pulmonary and Extrapulmonary Manifestations of Fungal Infections Misdiagnosed as Tuberculosis: The Need for Prompt Diagnosis and Management

Nanotechnology-Based Approaches for Voriconazole Delivery Applied to Invasive Fungal Infections

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