Abstract
Background: Chronic pulmonary aspergillosis (CPA) is a relatively rare infection, affecting mildly immunocompromised patients. Risk factors and their influence on survival are not well described in a low prevalence setting.
Aims and objectives: To describe risk factors, presentation, diagnostic workup and treatment of CPA in a low prevalence country.
Methods: All patients diagnosed with CPA from Jan 1 2009 to July 31 2014 in our tertiary hospital were included. Data on previous history, symptoms, clinical parameters, diagnostic workup, and treatment was extracted from their charts. Patients were followed up until Dec 31, 2014.
Results: During the 5.5 years inclusion period, 22 patients were diagnosed with CPA. We found a higher prevalence of COPD (36.4%) among these patients compared to previous studies (Lin SJ et al, Clin Inf Dis 2001, 32:358-366). Only one of the patients received systemic steroids. The prevalence of solid-organ tumour (40.9%) was higher than previously reported. None of these patients received anti-neoplastic therapy or was leucopenic at the time of diagnosis.
At follow up, 55.4% of patients had died. Mean survival time after diagnosis of CPA was 841 days (95% CI: 598-1085 days). Compared to survivors, deceased patients had a lower prevalence of active or previous mycobacterial infection (10% vs. 50%) but a higher prevalence of solid-organ tumours (70% vs. 17%).
Conclusions: COPD and solid-organ tumour may be under recognized risk factors for CPA, even without immunosuppressive therapy. These co-morbidities may affect mean survival after a diagnosis of CPA.
- Copyright ©ERS 2015
