Chronic Aspergillosis of the Lungs: Unravelling the Terminology and Radiology

Hedayati, Venus; Patel, Kalpana; Hansell, David M.

doi:10.1007/s00330-015-3690-7

Cited by 34 publications

(25 citation statements)

References 47 publications

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“…The different forms of Aspergillus infection are associated with significantly different morbidity and mortality rates. [ 18 ] If the lung function permits, surgical removal of the lesion is the best choice for patients with simple aspergilloma. [ 19 ] However, benefit from the operation in CCPA patients is much less.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and diagnosis of chronic pulmonary aspergillosis in Chinese patients

et al. 2017

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Chronic pulmonary aspergillosis (CPA) has recently been recognized as a significant global health burden. In China, the diagnosis of CPA is still unfamiliar to most doctors. The aim of this study was to demonstrate the clinical manifestations and diagnoses of CPA in China.A multidisciplinary team of doctors retrospectively screened 690 records of patients diagnosed with pulmonary aspergillosis from January 2000 to December 2016 at Peking Union Medical College Hospital, Beijing, China. Of these, 69 patients were diagnosed with CPA. The patients’ clinical characteristics were then retrieved and analyzed. Demographic, laboratory, and radiological data for these patients were compared by CPA type.Of the 69 patients diagnosed with CPA, 10 patients were diagnosed with chronic cavitary pulmonary aspergillosis (CCPA), 15 patients with semi-invasive aspergillosis (SAIA), 41 patients with simple aspergilloma, and 3 patients with Aspergillus nodule. Further, 53.3% of the SAIA patients were obviously immunocompromised, and 60% of the CCPA patients, 26.7% of the SAIA patients, 7.3% of the simple aspergilloma cases were mildly immunocompromised. Previous underlying lung abnormalities were observed in 20% of CCPA patients, 53.3% of SAIA patients, and 80.5% of simple aspergilloma patients. The most common symptoms in the CPA patients were cough (92.8%), hemoptysis (63.8%), chronic sputum (23.2%), and fever (17.4%). The most common computerized tomography abnormalities were cavities (94.2%), nodule (84.1%), consolidation (4.3%), pleural thickening (2.9%), and infiltration (2.9%). CCPA, SAIA and simple aspergilloma patients were significantly different with respect to their course before diagnosis, constitutional symptoms, fever, hemoptysis, breathlessness, white blood cell count, erythrocyte sedimentation rate, high-sensitivity C-reactive protein count, presence of nodule, and presence of a solitary lesion (all P < .05). Furthermore, SAIA patients had a significantly shorter course before diagnosis and a significantly higher white blood cell count compared with CCPA patients (both P < .01).In China, underlying systemic immunocompromising conditions and lung diseases with mechanical impediments contribute to CPA. Simple aspergillosis was the most common diagnosis in CPA patients. The imaging characteristics of simple aspergillosis and Aspergillus nodules were quite discriminable, while CCPA, and SAIA were similar in their clinical and radiological features. Distinguishing between CCPA and SAIA depends mainly on the physician's clinical judgment.

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Section: Discussionmentioning

confidence: 99%

Clinical features and diagnosis of chronic pulmonary aspergillosis in Chinese patients

et al. 2017

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“…Chest imaging remains an important diagnostic modality. A chest X-ray or computed tomography (CT) scan can reveal one or more cavities, typically within the upper lobes, of variable size, with or without the presence of pleural thickening and fibrosis (Desai et al, 2015). Cavities can be thin-or thick-walled, and may or may not contain fungal balls.…”

Section: Chronic Pulmonary Aspergillosis: Clinical Picture and Managementioning

confidence: 99%

Post tuberculosis treatment infectious complications

Hsu

Irfan

Jabeen

et al. 2020

International Journal of Infectious Diseases

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Following greater attention and follow-up of patients with treated pulmonary tuberculosis (TB), it has emerged that infections are more likely to occur in this cohort of patients. This comes as no surprise, as pulmonary TB is a destructive process that leads to cicatrization, alteration of parenchyma, bronchiectasis, and scarring of the lung, with reduction of lung volumes and an impact on pulmonary function. In addition to relapse and re-infection with TB, other pathogens are increasingly recognized in post-TB patients. This paper serves as a summary and guide on how to approach the post-TB patient with new signs and symptoms of pulmonary infection in order to ensure optimal management and rehabilitation.

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“…CPA in general has a predilection for the upper lobes of the lungs [34]. CT scan provides more detailed evaluation of the lung parenchyma than plain films [57]. Many features of radiographic findings show significant overlap between the spectrum of diseases.…”

Section: Diagnosismentioning

confidence: 99%

Advances in the Diagnosis and Management of Pulmonary Aspergillosis

Gao

Soubani

2020

Advances in Respiratory Medicine

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Aspergillus is a mould that is ubiquitous in nature and may lead to a variety of infectious and allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients appear to be at an increased risk as well. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic pulmonary aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Recently, the European Society for Clinical Microbiology and Infectious Diseases provided a more robust sub-classification of this entity that allows for a straightforward approach to diagnosis and management. Allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. It also details the role of noninvasive tests in the diagnosis of Aspergillus related lung diseases and advances in the management of these disorders.

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Chronic Aspergillosis of the Lungs: Unravelling the Terminology and Radiology

Abstract: • The classification of Aspergillus -related lung disease is mired in confusion. • The chronic form of Aspergillus infection is associated with significant morbidity and mortality. • Progressive consolidation and cavitation with intracavitary material is the radiological hallmark.

Cited by 34 publications

References 47 publications

Clinical features and diagnosis of chronic pulmonary aspergillosis in Chinese patients

Clinical features and diagnosis of chronic pulmonary aspergillosis in Chinese patients

Post tuberculosis treatment infectious complications

Advances in the Diagnosis and Management of Pulmonary Aspergillosis

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