Risk factors for chronic pulmonary aspergillosis in a low prevalence country and their effect on survival

2015 ◽  
Author(s):  
Nils Hoyer ◽  
Jørgen Vestbo
Keyword(s):  
Risk Factors ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis ◽  
Low Prevalence

scholarly journals The Efficacy and Safety of Surgical Treatment for Patients With Tuberculosis Destroyed Lung With or Without Chronic Pulmonary Aspergillosis

2021 ◽  
Author(s):  
Hongyun Ruan ◽  
Changfan Gong ◽  
Jinxiang Wang
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Efficacy And Safety ◽  
Pulmonary Aspergillosis ◽  
Preoperative Serum ◽  
Chronic Pulmonary Aspergillosis ◽  
Independent Risk Factors ◽  
Destroyed Lung

Abstract Background To evaluate the efficacy and safety of surgical treatment of tuberculosis destroyed lung (TDL), and the influence of chronic pulmonary aspergillosis (CPA) on the outcomes of surgical treatment of TDL. Methods We performed a retrospective analysis of 113 patients with TDL who underwent surgical treatment from January 2005 to December 2019. Among them, 30 of these cases were complicated with CPA. The patients were divided into two groups: TDL group and TDL + CPA group. We analyzed the effectiveness and safety of surgical treatment of TDL, and further compared the effectiveness and safety of surgical treatment of TDL with or withoutthe presence of CPA. Results The TDL + CPA group had a significantly higher age (P=0.003), symptoms of hemoptysis (P=0.000), and a higher proportion of patients with preoperative serum albumin <30 g/L (P=0.014) as compared with TDL group. For all enrolled patients, the incidence of severe postoperative complications was 12.4% (14/113) and the postoperative mortality within 30 days after discharge was 4.4% (5/113). 86.7% (98/113) of the patients recovered and discharged, the incidence of severe postoperative complications in the TDA + CPA group was higher than that of TDL group (23.3% vs 8.4%, P = 0.034), although there was no difference in mortality between the two groups (P = 1.000). A binary logistic regression analysis showed that the independent risk factors for severe postoperative complications were male (OR 25.24, 95% CI 2.31–275.64; P = 0.008) and age ≥ 40 years (OR 10.34, 95% CI 1.56–68.65; P = 0.016). Conclusion Surgical treatment for patients with TDL is effective with an acceptable mortality rate whether or not the disease is complicated with CPA. The independent risk factors identified for severe postoperative complications in patients with TDL were male and ≥ 40 years old. It implies that when treating patients with TDA + CPA, particular attention should be paid to these patients who have these independent risk factors to avoid a poor outcome.

Risk factors for chronic pulmonary aspergillosis in post-TB patients

2021 ◽  
Vol 25 (4) ◽  
pp. 324-326
Author(s):  
R. Singla ◽  
R. Singhal ◽  
R. Rathore ◽  
A. Gupta ◽  
P. Sethi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

Risk factors and treatment outcomes in patients with chronic pulmonary aspergillosis

2016 ◽  
Author(s):  
Kshitij Agarwal ◽  
Anuradha Chowdhary ◽  
M. Rahman ◽  
Anil Chaudhry ◽  
S.N. Gaur
Keyword(s):  
Risk Factors ◽  
Treatment Outcomes ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Risk factors for relapse of chronic pulmonary aspergillosis after discontinuation of antifungal therapy

2020 ◽  
Vol 5 ◽  
pp. 100015 ◽  
Author(s):  
Felix Bongomin ◽  
Akaninyene Otu ◽  
Chris Harris ◽  
Philip Foden ◽  
Chris Kosmidis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antifungal Therapy ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Clinical manifestations, associated risk factors and treatment outcomes of Chronic Pulmonary Aspergillosis (CPA): Experiences from a tertiary care hospital in Lahore, Pakistan

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259766
Author(s):  
Waqas Akram ◽  
Muhammad Bilal Ejaz ◽  
Tauqeer Hussain Mallhi ◽  
Syed Azhar bin Syed Sulaiman ◽  
Amer Hayat Khan
Keyword(s):  
Risk Factors ◽  
Treatment Response ◽  
Hematological Malignancies ◽  
Clinical Manifestations ◽  
Response Rates ◽  
Pulmonary Aspergillosis ◽  
Factors Associated ◽  
Icu Admission ◽  
Chronic Pulmonary Aspergillosis ◽  
The Mean

Background Chronic pulmonary aspergillosis (CPA) has a wide spectrum of illnesses depending on the progression of the disease and comorbid conditions. However, there is an inadequacy of investigations regarding clinical, laboratory, risk factor and prognostic data on CPA. The current study is aimed to consider the clinical manifestations, risk factors and outcomes of CPA. Methodology Retrospective records of all patients with a confirmed diagnosis of CPA who sought treatment at Gulab Devi Chest Hospital Lahore, Pakistan from January 2017 to December 2019 were evaluated. Data regarding demographics, clinical manifestations, comorbidities, radiographic and microbiological findings, length of hospital stay (LOS) and intensive care unit (ICU) admission was collected and analyzed to identify the factors associated with mortality. The independent factors associated with mortality were also identified by appropriate analyses. Results A total of 218 CPA patients were included in this study. The mean age was 45.75 ± 6.26 years. Of these, 160 (73.4%) were male, and 65 (29.8%) had diabetes. The mean LOS was 18.5 ± 10.9 days. The most common type of CPA was simple aspergilloma (56%) followed by chronic cavitary pulmonary aspergillosis (CCPA) (31.2%). About one half of the patients had a history of pulmonary tuberculosis (TB) and treatment response rates were low in patients with active TB. The overall mortality rate was 27.1%. ICU admission was required for 78 (35.8%) patients. Diabetes mellitus (DM), hematological malignancies and chronic kidney disease (CKD) were the common underlying conditions predicting a poor outcome. Mean LOS, hematological malignancies, consolidation and ICU admission were identified as the independent factors leading to mortality. Conclusions CPA had a significant association with TB in the majority of cases. Treatment response rates in cases with active TB were comparatively low. Cases with high mean LOS, hematological malignancies, consolidation, ICU admission, CKD and DM experienced poor outcomes. High mean LOS, hematological malignancies, consolidation and ICU stay were identified as independent risk factors for mortality. Future large prospective studies, involving aspergillus specific immunoglobulin G (IgG) antibody testing, are required for a better understanding of CPA in Pakistan.

scholarly journals Risk factors for the development of chronic pulmonary aspergillosis in patients with nontuberculous mycobacterial lung disease

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0188716 ◽  
Author(s):  
Byung Woo Jhun ◽  
Woo Jin Jung ◽  
Na Young Hwang ◽  
Hye Yun Park ◽  
Kyeongman Jeon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Disease ◽  
Pulmonary Aspergillosis ◽  
Nontuberculous Mycobacterial Lung Disease ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard Kwizera ◽  
Andrew Katende ◽  
Felix Bongomin ◽  
Lydia Nakiyingi ◽  
Bruce J. Kirenga
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Diagnostic Criteria ◽  
Tertiary Care ◽  
Chest Imaging ◽  
Resource Limited Settings ◽  
Pulmonary Aspergillosis ◽  
Resource Limited ◽  
Chronic Pulmonary Aspergillosis ◽  
Hiv Negative

Abstract Background Diagnosis of chronic pulmonary aspergillosis (CPA) is based on a combination of clinical symptomatology, compatible chest imaging findings, evidence of Aspergillus infection and exclusion of alternative diagnosis, all occurring for more than 3 months. Recently, a rapid, highly sensitive and specific point-of-care lateral flow device (LFD) has been introduced for the detection of Aspergillus-specific immunoglobulin (Ig)G, especially in resource-limited settings where CPA is underdiagnosed and often misdiagnosed as smear-negative pulmonary tuberculosis (PTB). Therefore, in our setting, where tuberculosis (TB) is endemic, exclusion of PTB is an important first step to the diagnosis of CPA. We used the recently published CPA diagnostic criteria for resource-limited settings to identify patients with CPA in our center. Case presentation Three Ugandan women (45/human immunodeficiency virus (HIV) negative, 53/HIV infected and 18/HIV negative), with a longstanding history of cough, chest pain, weight loss and constitutional symptoms, were clinically and radiologically diagnosed with PTB and empirically treated with an anti-tuberculous regimen despite negative microbiological tests. Repeat sputum Mycobacteria GeneXpert assays were negative for all three patients. On further evaluation, all three patients met the CPA diagnostic criteria with demonstrable thick-walled cavities and fungal balls (aspergilomas) on chest imaging and positive Aspergillus-specific IgG/IgM antibody tests. After CPA diagnosis, anti-TB drugs were safely discontinued for all patients, and they were initiated on capsules of itraconazole 200 mg twice daily with good treatment outcomes. Conclusions The availability of simple clinical diagnostic criteria for CPA and a LFD have the potential to reduce misdiagnosis of CPA and in turn improve treatment outcomes in resource-limited settings.

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