Chronic fibrosing pulmonary aspergillosis: a cause of 'destroyed lung' syndrome. Issue 4 (3rd April 2017)

• Record Type: Journal Article
• Authors: Kosmidis, Chris; Newton, Pippa; Muldoon, Eavan G.; Denning, David W.
• Is Part Of: Infectious diseases. Volume 49:Issue 4(2017:Apr.)
• Page Start: 296
• Page End: 301
• Publication Date: 2017-04-03
• Subjects: Chronic pulmonary aspergillosis -- fibrosis -- destroyed lung -- outcome -- case series -- radiology; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1080/23744235.2016.1232861
• Languages: English
• ISSNs: 2374-4235

Abstract

Abstract: Background: Chronic pulmonary aspergillosis (CPA) has substantial impact on quality of life. A subset of patients develops significant pulmonary fibrosis, identified either on biopsy or radiologically. The term chronic fibrosing pulmonary aspergillosis (CFPA) has been suggested. Methods: We describe 11 patients with CFPA referred to our centre. Results: Mean age was 58.5 years and five were male. In nine, fibrosis was already evident on presentation, while in two it developed 3 and 6 years later. The predominant radiological feature was extensive or complete involvement of the entire lung, with minimal contralateral involvement. All patients received prolonged antifungal treatment. Two patients had surgical treatment; both developed post-operative complications. The contralateral lung remained free of significant disease in all but three patients. Conclusions: CFPA is a rare complication of CPA that is usually evident on presentation, but may develop after years in patients not on antifungals. Fibrosis resembles the 'destroyed lung' syndrome described after treated tuberculosis.