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Updated: Dec 24, 2025
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
[Aspergillus-related respiratory conditions and COPD: Diagnostic challenges]
N Ehret1, N Carlier1, J Marey1
1Service de pneumologie, université Paris Descartes, groupe hospitalier Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Introduction:
The relations between chronic obstructive pulmonary disease (COPD) and respiratory diseases due to Aspergillus spp. are not well understood.
Methods:
We analysed a retrospective series of patients hospitalized with a diagnosis of COPD and respiratory disease due to Aspergillus. Patients were identified between 2010 and 2015 from the medico-administrative database of Cochin hospital, Paris. Historical, clinical, biological, microbiological and imaging data were collected and described. Diagnoses were reclassified based on reference definitions and classifications from the literature. Patients were classified according to the type of Aspergillus-related diseases and risk factors were described.
Results:
Forty patients were identified. Classifiable Aspergillus-related respiratory conditions were confirmed in 26 of them including 12 allergic bronchopulmonary aspergillosis (ABPA), 8 chronic pulmonary aspergillosis (CPA), 1 invasive pulmonary aspergillosis (IPA) and 3 diagnostic associations ABPA/CPA. Other respiratory comorbidities were present in all cases of CPA and immunodepression was recorded for semi-invasive and invasive forms. Finally, 16 patients could not be classified, among whom Aspergillus related lung disease was considered as likely in one-half.
Conclusion:
The complexity of the diagnosis of pulmonary aspergillosis is related to its multiple types with sometimes unclear distinctions. Any type of pulmonary aspergillosis can be observed in patients with COPD, depending on associated risks factors. It would be helpful to establish specific classifications adapted to patients with COPD. This will require larger, prospective, multicentre studies.
Insights
Chronic obstructive pulmonary disease (COPD) patients can develop various Aspergillus respiratory infections, including allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). Further research is needed to clarify these complex diagnoses in COPD patients.
Area of Science:
- Pulmonology
- Infectious Diseases
- Medical Mycology
Background:
- The relationship between chronic obstructive pulmonary disease (COPD) and Aspergillus-related respiratory diseases remains unclear.
- Aspergillus species can cause a spectrum of pulmonary conditions, complicating diagnosis in patients with underlying lung disease.
Purpose of the Study:
- To investigate the types and characteristics of Aspergillus-related respiratory diseases in patients with COPD.
- To identify risk factors associated with different forms of pulmonary aspergillosis in COPD patients.
Main Methods:
- Retrospective analysis of patients hospitalized with COPD and Aspergillus infection between 2010-2015.
- Review of clinical, biological, microbiological, and imaging data; reclassification of diagnoses based on established criteria.
- Classification of patients by Aspergillus-related disease type and description of associated risk factors.
Main Results:
- Forty patients with COPD and suspected Aspergillus infection were identified; 26 had classifiable conditions.
- Confirmed diagnoses included allergic bronchopulmonary aspergillosis (ABPA) in 12, chronic pulmonary aspergillosis (CPA) in 8, and invasive pulmonary aspergillosis (IPA) in 1.
- All CPA cases had respiratory comorbidities, and invasive forms were associated with immunodepression; 16 patients remained unclassified.
Conclusions:
- Pulmonary aspergillosis in COPD patients presents diagnostic challenges due to diverse forms and overlapping features.
- All types of pulmonary aspergillosis can occur in COPD, influenced by specific risk factors.
- Development of tailored classifications and prospective multicenter studies are essential for better understanding and management.
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