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Chronic Aspergillosis of the Lungs: Unravelling the Terminology and Radiology
S R Desai1, V Hedayati, K Patel
1The Department of Radiology, King's Health Partners, King's College London, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK, sujal.desai@nhs.net.
Unlabelled:
The propensity for Aspergillus spp. to cause lung disease has long been recognised but the satisfactory classification of these disorders is challenging. The problems caused by invasive disease in severely neutropenic patients, saprophytic infection of pre-existing fibrotic cavities and allergic reactions to Aspergillus are well documented. In contrast, a more chronic form of Aspergillus-related lung disease that has the potential to cause significant morbidity and mortality is under-reported. The symptoms of this form of Aspergillus infection may be non-specific and the radiologist may be the first to suspect a diagnosis of chronic pulmonary aspergillosis. The current review considers the classification conundrums in diseases caused by Aspergillus spp. and discusses the typical clinical and radiological profile of patients with chronic pulmonary aspergillosis.
Key Points:
• The classification of Aspergillus -related lung disease is mired in confusion. • The chronic form of Aspergillus infection is associated with significant morbidity and mortality. • Progressive consolidation and cavitation with intracavitary material is the radiological hallmark.
Insights
Aspergillus lung disease classification is complex. A chronic form, often under-diagnosed, causes significant illness and is characterized by progressive consolidation and cavitation on imaging.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Aspergillus species are known to cause various lung diseases.
- Established classifications cover invasive, saprophytic, and allergic forms.
- A chronic, under-reported form of Aspergillus lung disease poses significant health risks.
Purpose of the Study:
- To review the classification challenges of Aspergillus-related lung diseases.
- To describe the clinical and radiological features of chronic pulmonary aspergillosis.
Main Methods:
- Literature review focusing on Aspergillus lung disease classification.
- Analysis of clinical and radiological profiles of chronic pulmonary aspergillosis.
Main Results:
- Classification of Aspergillus lung diseases remains problematic.
- Chronic pulmonary aspergillosis is associated with substantial morbidity and mortality.
- Radiological hallmarks include progressive consolidation, cavitation, and intracavitary material.
Conclusions:
- The classification of Aspergillus-related lung disease requires clarification.
- Chronic pulmonary aspergillosis represents a serious clinical entity.
- Radiological findings are crucial for suspecting and diagnosing this condition.
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