Abstract
Background
Chronic pulmonary aspergillosis (CPA) usually occurs in patients with underlying pulmonary disease. The most frequent underlying condition is history of mycobacterial infection including non-tuberculous mycobacteriosis (NTM). However, the risk factor for progression to CPA in the patients with NTM has not been clear.
Method
We analyzed the medical records of 378 NTM patients who fulfilled 2008 ATS diagnostic criteria between 1997 and 2011 retrospectively. Detection of aspergillus precipitin was applied using agarose immunodiffusion method when the patients were thought to being development of CPA clinically. If the aspergillus precipitin had been converted to positive, we defined the patients as CPA. The clinical data of CPA group were compared with those of non-CPA group.
Result
Thirty-seven out of 378 NTM patients (9.8%) were defined as CPA during study period. There were no significant differences with respect to sex, age, species, diagnostic procedure and presence of diabetes mellitus between CPA and non-CPA groups. Cavitary formation in non-tuberculous mycobacterial infection is the significant risk for development of chronic pulmonary asapergillosis (p < 0.01). In addition to it, larger amount of bacilli in sputum at the time of diagnosis increased the risk to CPA (p <0.05).
Conclusions
The worldwide rise in prevalence of NTM may lead to increasing the patients of CPA underlying with NTM. Because of the chronic pulmonary aspergillosis is known to be refractory pulmonary disease, therefore, it is important to understand the predictive factor in NTM patients that proceeds to chronic pulmonary aspergillosis.
- © 2014 ERS
