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Prevalence of chronic pulmonary aspergillosis in patients with tuberculosis from Iran

M T Hedayati1, Y Azimi, A Droudinia

  • 1Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Km 18 Khazarabad Road, P.O. Box 48175-1665, Sari, Iran, hedayatimt@gmail.com.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|May 25, 2015
PubMed

Insights

Chronic pulmonary aspergillosis (CPA) is common in tuberculosis (TB) patients in Iran. Researchers found that 11.3% of TB patients had chronic cavitary pulmonary aspergillosis (CCPA), and 2.4% had aspergilloma.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Aspergillus infection can cause chronic pulmonary aspergillosis (CPA) in patients with lung disease, including tuberculosis (TB).
  • CPA encompasses chronic cavitary pulmonary aspergillosis (CCPA) and aspergilloma.
  • Assessing CPA prevalence in TB patients is crucial for understanding co-infection burden.

Purpose of the Study:

  • To evaluate the prevalence of CPA in patients with current or previous tuberculosis (TB) in Iran.
  • To identify clinical and radiological features associated with CPA in TB patients.
  • To assess the utility of culture and serological methods in diagnosing CPA.

Main Methods:

  • A cohort of 124 TB patients (94 current, 30 previous) were studied over one year.
  • Sputum samples were analyzed using direct microscopic examination (DME) and fungal culture for Aspergillus.
  • Serum-specific IgG against Aspergillus fumigatus was measured using ELISA; clinical and radiological data were collected.

Main Results:

  • Out of 124 TB patients, 48 (38.7%) had residual cavities, and 18 (14.5%) had cavities with pleural thickening.
  • Direct microscopic examination (DME) detected fungal hyphae in 10 patients; Aspergillus fumigatus was cultured from 14 samples.
  • Fifty-five patients (44.3%) tested positive for serum-specific IgG. Three patients (2.4%) met criteria for aspergilloma, and 14 (11.3%) for CCPA.

Conclusions:

  • Chronic pulmonary aspergillosis (CPA) is a significant co-infection in tuberculosis (TB) patients in Iran.
  • The study highlights the importance of investigating CPA in individuals with a history of TB, particularly those with residual lung cavities.
  • Combined diagnostic approaches, including serology, are valuable for identifying CPA in this population.

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