Table 3– Underlying conditions identified in analysed chronic pulmonary aspergillosis (CPA) cases and comparison to literature
Underlying conditionFrequency of 126 CPA casesNotesPrevious reports of incidences of being an underlying disease for CPA
TotalAs primary
Classical tuberculosis21 (16.7)20 (15.9)One also had thoracic surgery and is also recorded in this categoryFor TB and/or atypical TB: 9/18 (50%) of CPA cases 4
Non-tuberculous mycobacterial infection20 (15.9)18 (14.3)M. malmoense (n = 7), M. avium (n = 2), M. avium intracellularae (n = 1), M. kansasii (n = 2), M. xenopi (n = 2), unidentified (primary n = 2, in all n = 3), M. fortuitum (n = 1 in all), both M. avium + M. malmoense (n = 2)13/24 (54%) of CPA cases 5
27/85 (31.2%) of aspergilloma cases 7
54/67 (80.6%) of aspergilloma cases 8
31/41 (75.6%) of aspergilloma cases 9+
ABPA±asthma18 (14.3)15 (11.9)Two are cases of probable ABPA; these had asthmaFive ABPA cases were without asthma recorded in the notes10/85 (11.8%) of aspergilloma cases 7
COPD and/or emphysema±bullae42 (33.3)12 (9.5)Five of the COPD patients also had bullae10/18 (55.5%) of CPA cases 4
10/24 (42%) of CPA cases 5
Pneumothorax±bullae21 (16.7)12 (9.5)Six pneumothorax patients also had bullae3/18 (16.6%) of CPA cases 4
3/24 (12%) of CPA cases 5
Lung cancer survivor13 (10.3)12 (9.5)Six patients also had thoracic surgery, four also had COPD and/or emphysemaThey are also recorded in these categoriesNo published data, but data for thoracic surgery, COPD and chest radiotherapy
Pneumonia#28 (22.2)10 (7.9)One is community-acquired Aspergillus pneumonia in non-immunocompromised patients (both categories)3/25 (12%) of aspergilloma cases 10§
8/85 (9.4%) of aspergilloma cases 7ƒ
Sarcoidosis9 (7.1)9 (7.1)4/24 (17%) of CPA cases 5
4/25 (16%) of aspergilloma cases 10
10/85 (11.8%) of aspergilloma cases 7
Thoracic surgery18 (14.3)6 (4.8)Six were cases of surgery for lung cancer, one was for TB, these patients are also included in the TB and lung cancer categoriesThey did not have thoracic surgery as the primary underlying condition2/18 (11.1%) of CPA cases 4
2/24 (8%) of CPA patients 5
Rheumatoid arthritis, no immunosuppression5 (4.0)4 (3.2)2/85 (2.4%) of aspergilloma cases 7
Asthma, no ABPA or SAFS13 (10.3)3 (2.4)This group does not include patients with SAFS or ABPA, even though these also have asthma1/18 (5.6%) of CPA cases 4
3/24 (12%) of CPA cases 5
SAFS+asthma3 (2.4)2 (1.6)No published data; only recently recognised as separate entity to ABPA
Bullae, no COPD and no pneumothorax2 (1.6)1 (0.8)This group does not include patients with pneumothorax+bullae or COPD+bullaeNo published data on bullae alone, but one case of multiple bullae with pneumothorax and emphysema 4
SAIA1 (0.8)1 (0.8)This patient developed SAIA as a result of immunosuppressants for autoimmune hepatitis, which then led to CCPANo published data; may be due to variations in condition classification/nomenclatureOne report of CCPA progressing to SAIA 4
Ankylosing spondylitis/Kyphoscoliosis5 (4.0)0 (0)Four are kyphoscoliosis and one is ankylosing spondylitis2/85 (2.4%) of aspergilloma cases 7
2/18 (11.1%) of CPA cases 4
Other7 (5.6)0 (0)Includes alcohol excess (n = 2), chest radiotherapy (n = 1), dextrocardia (n = 1), smoke inhalation (n = 2) and HIV (n = 1)2/18 (11.1%) of CPA cases 4
2/24 (8%) of CPA patients 5
None1 (0.8)1 (0.8)For one patient no underlying condition could be identified9/59 in a review of CNPA cases 3
Total n232126
  • Data are presented as n (%), unless otherwise stated. ABPA: allergic bronchopulmonary aspergillosis; COPD: chronic obstructive pulmonary disease; SAFS: severe asthma with fungal sensitisation; SAIA: subacute invasive aspergillosis; TB: tuberculosis; CCPA: chronic cavitary pulmonary aspergillosis; CNPA: chronic necrotising pulmonary aspergillosis. #: community-acquired pneumonia requiring hospitalisation; : Taiwanese study; +: Indian study; §: Pneumocystis carinii pneumonia; ƒ: pneumonia and lung abscess.