Prevalence of chronic pulmonary aspergillosis regarding time of tuberculosis diagnosis in Brazil
- 15 May 2022
- Vol. 65 (7), 715-723
- https://doi.org/10.1111/myc.13465
Abstract
Background Data on the prevalence of chronic pulmonary aspergillosis (CPA) in patients with active or cured tuberculosis (TB) are scarce, mainly due to diagnostic difficulties. The diagnosis of CPA is based on pulmonary symptoms and chest computed tomography (CT) scans and is considered confirmed when there is microbiological or serological evidence of Aspergillus spp. infection. Objectives To estimate the prevalence of CPA in patients treated or undergoing treatment for PTB, seen in two referral hospitals in Mato Grosso do Sul, Brazil. Patients and Methods A total of 193 consecutive patients who were treated or previously treated for pulmonary tuberculosis underwent prospective evaluation: (a) clinical evaluation; (b) chest CT scan; (c) sputum examination-culture for fungi and smears for direct mycology; (d) detection of anti-Aspergillus fumigatus antibodies using an enzyme-linked immunosorbent assay Platelia (R) test; and (e) anti-Aspergillus spp. antibodies were assessed via a DID test. Results The global prevalence of CPA was 10.9% (95% confidence interval, 7.2%-16.1%), but it increased with the time of TB diagnosis. The variables independently associated with CPA were previous pulmonary tuberculosis over 4 years ago and haemoptysis. Cavities, pleural thickening and the presence of a fungal ball were the most frequent tomographic findings in patients with CPA. Conclusions The high prevalence observed and its increase over time suggest the need for continuous surveillance of CPA in patients with active or previous pulmonary tuberculosis and throughout life, with clinical, tomographic and serological evaluations (ELISA) for a timely diagnosis and a better prognosis.Keywords
Funding Information
- Conselho Nacional de Desenvolvimento Científico e Tecnológico (312910/2020‐7, 431776/2016‐4)
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001)
- Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (71/000.478/2021)
This publication has 42 references indexed in Scilit:
- Hidden Killers: Human Fungal InfectionsScience Translational Medicine, 2012
- Global burden of chronic pulmonary aspergillosis complicating sarcoidosisEuropean Respiratory Journal, 2012
- Clinical characteristics and prognosis of chronic pulmonary aspergillosisRespiratory Medicine, 2012
- Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosisBulletin of the World Health Organization, 2011
- The importance of serological assays in diagnosing acute pulmonary histoplasmosisJournal of Venomous Animals and Toxins including Tropical Diseases, 2009
- Significance of Aspergillus fumigatus Isolation from Respiratory Specimens of Nongranulocytopenic PatientsEuropean Journal of Clinical Microbiology & Infectious Diseases, 2003
- Surgical treatment of pulmonary aspergilloma: Current outcomeThe Journal of Thoracic and Cardiovascular Surgery, 2000
- Aspergillus fumigatus fungus ball in hospitalized patients with chronic pulmonary disease: usefulness of double immunodiffusion test as a screening procedureMemórias do Instituto Oswaldo Cruz, 1988
- Aspergilloma and residual tuberculous cavities—the results of a resurvey: A report from the Research Committee of the British Thoracic and Tuberculosis AssociationTubercle, 1970
- ANTIGEN‐ANTIBODY REACTIONS IN GELSActa Pathologica Microbiologica Scandinavica, 1953