Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma
Open accessAbstract
Chronic pulmonary aspergillosis (CPA) is a condition caused by the ubiquitous fungus Aspergillus fumigatus in non-immunocompromised individuals. Numerous underlying conditions have been associated with CPA. Details of the underlying conditions of 126 CPA patients attending our tertiary referral clinic from all over the UK were extracted from the clinical notes, and the distribution of these underlying conditions was analysed. For those with several underlying pulmonary conditions, one was nominated as the primary condition. Many patients presented with multiple underlying conditions, and a total of 232 underlying conditions were identified for the 126 patients. Previous classical tuberculosis and non-tuberculous mycobacterial infection were the most common primary underlying conditions (15.3% and 14.9%, respectively). Others included allergic bronchopulmonary aspergillosis (ABPA), chronic obstructive pulmonary condition (COPD) and/or emphysema, pneumothorax and prior treated lung cancer. Some conditions were found more often as one of multiple underlying conditions, while others were found only as secondary underlying conditions. Tuberculosis, non-tuberculous mycobacterial infection and ABPA remain the predominant risk factors for development of CPA, with COPD, prior pneumothorax or treated lung cancer also relatively common among our referrals. Many patients have multiple underlying pulmonary conditions. CPA should be considered when upper lobe cavitary or fibrotic disease and systemic symptoms are present in those with lung disease.
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Prior TB is perhaps the most common underlying condition in CPA; post-tuberculous cases probably represent 50% (range 20-85%) of the total CPA caseload.
“Prior TB is perhaps the most common underlying condition in, C.P.A.; post-tuberculous cases probably represent 50% (range 20–85%) [134] of the total CPA caseload”
From Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision (2017) · cites this paper as [134]
The Tuberculosis section (page unavailable) identifies tuberculosis as the most common primary underlying condition in this cohort and reports 50–72% in some earlier studies. It does not estimate that post-tuberculous cases make up 50% (range 20–85%) of the total CPA caseload; its own figure is 30.2%, combining classical tuberculosis with nontuberculous mycobacterial infection. (LLM, conf=0.88)
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- Authors
- Smith, N. L., & Denning, D. W.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- Corresponding author
- Denning, D.W.
- ORCID
- Denning, D.W.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2010-07-01
- Volume
- 37
- Issue
- 4
- Pages
- 865-872
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2144901153
- Cited by
- 449
- References
- 35
- Citations by year
- 2026: 26 · 2025: 19 · 2024: 30 · 2023: 33 · 2022: 33 · 2021: 39 · 2020: 44 · 2019: 25 · 2018: 29 · 2017: 29 · 2016: 28 · 2015: 31 · 2014: 28 · 2013: 20 · 2012: 19
- FWCI
- 11.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Keywords
- chronic pulmonary aspergillosis, Aspergillus fumigatus, tuberculosis, nontuberculous mycobacterial infection, allergic bronchopulmonary aspergillosis, chronic obstructive pulmonary disease, emphysema, pneumothorax, lung cancer, risk factors, cavitary lung disease, fibrotic lung disease
- MeSH terms
- Adult, Aged, Aged, 80 and over, Aspergillosis, Aspergillus fumigatus, Emphysema, Female, United Kingdom, Humans, Lung Neoplasms, Male, Middle Aged, Pneumothorax, Itraconazole, Pulmonary Disease, Chronic Obstructive, Pulmonary Aspergillosis
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