Clinical profile of pulmonary aspergilloma complicating residual tubercular cavitations in Northen Indian patients

Abstract

Background:Little is known regarding the clinical profile of Aspergilloma in Indian patients. Such a study was undertaken at Hospital for Chest and TB, Jaipur.Materials and Methods:Old, treated patients of pulmonary tuberculosis showing ball like lesion/s inside cavity/ies or a recent thickening of cavity wall were enrolled. Morning sputa samples were collected in the patients who were able to raise sputum and were examined by KOH mount and fungal culture. Serum anti-aspergillus antibodies were estimated in all the patients. Twenty normal healthy subjects were included to serve as control. All patients showing a positive or borderline positive serology were diagnosed as pulmonary aspergilloma (PA group). The remaining patients formed the non-aspergilloma group (Non PA group).Results:A total of 98 study patients could be classified as PA group (54 patients by serology alone, 44 patients by serology as well as sputum culture). The remaining 152 patients were classified as non PA group. Hemoptysis alone or along with other chest symptoms was significantly more common in PA group as compared to non PA group patients (P<0.001), more so in those with ball like lesions. But chest symptoms other than hemoptysis were more common in non PA group. Within the PA group, 21 (13 with ball like lesions and 8 with thickening of cavity wall) had clinical symptoms suggestive of CNPA and two patients (one each with ball like lesions and thickening of cavity wall) had clinical symptoms suggestive of ABPA.Conclusion:The clinical profile of pulmonary Aspergilloma in Indian patients is very protean ranging from saprophytic disease to CNPA and less commonly to ABPA.

Clinico-Microbiological Profile of Chronic Pulmonary Aspergillosis from a Tertiary Care Centre in Southern India

“…Chest X-ray was normal in 18.2% of patients with bronchopulmonary aspergillosis. Aspergillus fumigatus was the most Features Kurhade et al, [6] Shahid M et al, [9] david M denning et al, [18] pr Gupta et al, [19] hae-Seong nam et al, [20] present study …”

Pulmonary mycetoma

“…[1] Radiologically it presents as a ball-like lesion inside a cavity, partially surrounded by a radiolucent sign (Monod's sign). [2] CT is more reliable than chest radiograph in defining a fungus ball.…”

A comparative study of itraconazole in various dose schedules in the treatment of pulmonary aspergilloma in treated patients of pulmonary tuberculosis

“…Two additional morning sputa samples were collected and sent for KOH mount and fungal culture. Venous blood samples drawn from each patient were subjected to an estimation of anti-Asp-Ab as per the protocol used by Gupta et al [ 4 ]…”

“…[ 3 ] As most of these patients either do not expectorate or their sputa are negative for mycelia, the diagnosis of PA is mainly based on the detection of anti-aspergillus antibodies (anti-Asp-Ab) in their serum. [ 2 4 ]…”