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Open AccessArticle

Underlying Conditions and Clinical Spectrum of Chronic Pulmonary Aspergillosis (CPA): An Experience from a Tertiary Care Hospital in Karachi, Pakistan

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Department of Medicine, Jinnah Medical and Dental College, Karachi 74800, Pakistan
2
Section of Pulmonary and Critical care Medicine, Department of Medicine, Aga Khan University, Karachi 75300, Pakistan
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Department of Pathology& Laboratory Medicine, Aga Khan University, Karachi 75300, Pakistan
*
Author to whom correspondence should be addressed.
J. Fungi 2020, 6(2), 41; https://doi.org/10.3390/jof6020041
Received: 22 January 2020 / Revised: 5 March 2020 / Accepted: 6 March 2020 / Published: 26 March 2020
The incidence of chronic pulmonary aspergillosis (CPA) is especially increasing in high tuberculosis (TB) burden countries. Despite a high estimated CPA burden in Pakistan, actual data on CPA are not available. The aim of the current study is to determine the underlying conditions and clinical spectrum of CPA at a tertiary care hospital in Karachi, Pakistan. This is a retrospective chart review study in patients admitted with CPA from January 2012 to December 2017. A total of 67 patients were identified during the study period. Mean age of CPA patients was 45.9 ± 15 years, 44 (65.7%) were male and 19 (28.4%) had diabetes. The most common type of CPA was simple aspergilloma (49.2%) followed by chronic cavitary pulmonary aspergillosis (CCPA) (44.7%). TB was the underlying cause of CPA in 58 (86.6%) patients followed by bronchiectasis caused by allergic bronchopulmonary aspergillosis (ABPA) 8 (11.9%). Aspergillus flavus was identified in 17 (47.2%), followed by A. fumigatus in 13 (36.1%) CPA patients. Isolation of multiple Aspergillus species was found in 10 (25.6%) patients. Itraconazole was given in 27 (40.3%) patients and a combination therapy of itraconazole and surgery was given in 21 (31.34%) patients. We found aspergilloma and CCPA as the most prevalent forms of CPA in our setting. Further large prospective studies using Aspergillus specific immunoglobulin G (IgG) antibodies testing are required for better understanding of CPA in Pakistan. View Full-Text
Keywords: chronic pulmonary aspergillosis; structural lung diseases; developing country; Pakistan chronic pulmonary aspergillosis; structural lung diseases; developing country; Pakistan
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Iqbal, N.; Irfan, M.; Mushtaq, A.; Jabeen, K. Underlying Conditions and Clinical Spectrum of Chronic Pulmonary Aspergillosis (CPA): An Experience from a Tertiary Care Hospital in Karachi, Pakistan. J. Fungi 2020, 6, 41.

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