Chronic pulmonary aspergillosis: Characteristics of 30 nonimmunocompromised patients

Introduction: Chronic pulmonary aspergillosis (CPA) is a severe respiratory infection characterized by pulmonary cavities and increased levels of antibodies to Aspergillus specie. We describe 30 nonimmunocompromised patients with CPA. Materials and methods: Multidisciplinary working group devoted to epidemiological surveillance of invasive aspergillosis was created in our hospital in January 2000. Among 1545 alerts, 30 cases of CPA in nonimmunocompromised patients were identified. In a retrospective study, we investigated characteristics of patients with CPA. Results: 30 patients were identified. Their mean age was 69.2 years (interquartile range (IQR) 43.8 – 83.9 years) and 19 (63%) of the patients were men. 19 (63%) of patients had a smoking > 10 pack-years, 23 patients (77%) had COPD, 6 patients in GOLD stage IV and 8 patients in GOLD stage III. All had detectable Aspergillus spp precipitins and inflammatory markers. Aspergillus spp was isolated in respiratory specimens of 16 (53%) patients. The radiological improvement was essentially: excavations (n=19, 64%); consolidation (n=14, 47%); bronchiectasis (n=12, 40%), nodules (n=9, 30%) and sequelae of tuberculosis (n=5, 17). The average duration of follow up was 31.5 months (IQR 0.2 – 131 months). The average duration of treatment was 7, 6 months (IQR 0.2 – 23 months). The outcome was favorable in 18 (60%) patients and negative in 14 (40%) patients significantly correlated with the degree of bronchial obstruction. Conclusion: CPA typically occurs in patients with preexisting structural lung disease, and it causes significant respiratory and constitutional symptoms. Prospective studies are required to better characterize the profile of patients.