Chronic Pulmonary Aspergillosis in a Tertiary Care Center in Spain: A Retrospective, Observational Study.

Author: 

Aguilar-Company J, Martín MT, Goterris-Bonet L, Martinez-Marti A, Sampol J, Roldán E, Almirante B, Ruiz-Camps I.
2019 Jun 4. doi: 10.1111/myc.12950

Abstract: 

OBJECTIVE:

The aim of this study was to describe the characteristics of patients with chronic pulmonary aspergillosis (CPA) in a tertiary care center in Spain.

PATIENTS AND METHODS:

Retrospective cohort study of all patients diagnosed with CPA between January 2010 and December 2015. The patients were identified through the Microbiology registry. Demographic, clinical, laboratory, radiological, microbiological and clinical data were recorded. Patients were followed up for 12 months.

RESULTS:

53 patients were included; median age was 61.5 years. Forty-seven had a lung condition, 25 suffered from COPD, 19 an active malignancy, 10 had previous pulmonary tuberculosis and 9 lung insterstitial disease. Twenty-eight patients presented with chronic cavitary pulmonary form (CCPA) and 20 with subacute invasive aspergillosis (SAIA). Species identified were A. fumigatus (34), A. niger (5), A. terreus (4) and A. flavus (3). All-cause 1 year mortality was 56%. Predictors of mortality were cancer history (OR, 9.5; 95% CI, 2.54-35.51; p<0.01) and SAIA (OR, 5.49; 95% CI, 1.49-19.82; p<0.01). Previous pulmonary tuberculosis, surgery for the treatment of CPA, and CCPA were found to be associated with lower mortality (OR, 0.05; 95% CI, <0.01-0.47; p<0.01; OR, 0.16; 95% CI, 0.03-0.88; p=0.035 and OR 0.2, 95% CI, 0.01-0.67; p=0.01, respectively).

CONCLUSIONS:

This is the first study providing an overview of the features of CPA in patients from Spain. CCPA was the most frequent form of CPA and A. fumigatus the most frequently isolated species. Patients with cancer history and SAIA had a worse prognosis.

KEYWORDS:

Aspergillus infection; Chronic pulmonary aspergillosis; Fungal lung disease; Galactomannan; Immunocompromised host; Lung cancer; Mycoses