Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

Denning, David W.; Pleuvry, Alex; Cole, Donald C.

doi:10.2471/blt.11.089441

Cited by 361 publications

(399 citation statements)

References 31 publications

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“…Assuming that 3,175 (88%) of them survived to at least 12 months after diagnosis we estimate that annually at least 133 patients develop CPA following pulmonary tuberculosis, and the prevalence over 5 years is 420 patients. It was assumed that TB was the underlying diagnosis of CPA in 20% of cases [20][21], and so the total CPA prevalence is 2,100 patients.…”

Section: Resultsmentioning

confidence: 99%

“…It is assumed that 22% of patients with lung cavities, and 2% of those without cavities, following pulmonary tuberculosis (PTB) will develop chronic pulmonary aspergillosis (CPA) [20]. Patients with PTB are expected to represent ~25% of the total number of CPA cases annually [21] and so the total prevalence of CPA from any cause is estimated using the national PTB figures [20].…”

Section: Methodsmentioning

confidence: 99%

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Serious fungal infections in Ecuador

Zurita

Denning

Paz-y-Miño³

et al. 2017

Eur J Clin Microbiol Infect Dis

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Serious fungal infections in Ecuador

Zurita

Denning

Paz-y-Miño³

et al. 2017

Eur J Clin Microbiol Infect Dis

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“…Although pulmonary tuberculosis sequelae itself does not impair the systemic immune system, the pulmonary tuberculosis sequelaeinduced anatomical reconstruction can lead to weakness and local dysfunction of airway clearance. In a previous study that used modeling to estimate the global burden of CPA as the sequelae of pulmonary tuberculosis, the prevalence of CPA varied widely, with a lower prevalence in developed countries compared with developing countries (10). However, as the morbidity of tuberculosis in Japan remains higher than that of other developed countries, the prevalence of CPA is still high.…”

Section: Discussionmentioning

confidence: 99%

Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis

et al. 2016

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SUMMARY: Chronic pulmonary aspergillosis (CPA) is a refractory disorder that needs long-term antifungal treatment and occasionally results in fatal respiratory failure and hemoptysis. However, the pathological features of the disorder have not been thoroughly delineated. Thirty cases were therefore analyzed clinically and histologically to elucidate the pathophysiology of CPA. The subjects comprised 14 individuals who underwent surgical removal and 16 patients who died. No subject exhibited a severely immunocompromised state. The main symptoms included cough, hemosputum, and dyspnea. Chest computed tomography (CT) findings revealed a cavity, fungus ball, and consolidation and/or ground glass opacity (GGO); 27 serial CT scans showed enlarged consolidation and/or GGO (70z), dilatation of the cavity (26z), and extension to the opposite lung (22z). Histopathological findings revealed a cavity with ulceration, bronchitis, and various degrees of organizing pneumonia (OP) that were correlated with the area of consolidation and GGO on the CT scan. The essential pathophysiology of CPA can be understood as an active state of ulceration of the cavity and/or erosive bronchitis caused by contact with the fungus ball, which may play a significant role in the development of OP. Consequently, OP is thought to reflect respiratory failure that relates to the prognosis of CPA.

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“…Smith and Denning retrospectively evaluated 126 CPA patients and found that their major underlying conditions were tuberculosis (32.5%), ABPA (11.9%), treated lung cancer (9.5%), COPD and/or emphysema (9.5%), and pneumothorax (9.5%) [16]. Moreover, data from the World Health Organization (WHO) estimate that about 4.8% of pulmonary tuberculosis (PTB) patients around the world were at risk of CPA [19]. The global five-year period prevalence for CPA in PTB patients was calculated to be between 11-15%.…”

Section: Populations At Riskmentioning

confidence: 99%

“…Individuals with cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), tuberculosis, asthma, or receiving immunosuppressive therapy for cancer are at increased risk of developing CPA [9•,10•, [16][17][18][19][20] and Aspergillus spp. are commonly present in their respiratory tracts [21,22].…”

Section: Populations At Riskmentioning

confidence: 99%

An Invisible Threat: Mutation-Mediated Resistance to Triazole Drugs in Aspergillus

Pham

Lockhart

2012

Curr Fungal Infect Rep

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Aspergillosis has emerged as an important contributor to infection-related morbidity and mortality in susceptible populations. This comes at a time when we are also seeing an increase in the vulnerable populations themselves. At the same time, some parts of the world are reporting an increased incidence of aspergillosis refractory to triazole therapy. Resistance to triazole drugs may have major implications for aspergillosis management since our antifungal armamentarium is limited. This review gives an overview of populations at risk of developing aspergillosis and highlights resistance mechanisms that may contribute to morbidity and mortality in these vulnerable populations.

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Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

Cited by 361 publications

References 31 publications

Serious fungal infections in Ecuador

Serious fungal infections in Ecuador

Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis

An Invisible Threat: Mutation-Mediated Resistance to Triazole Drugs in Aspergillus

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