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Updated: Aug 19, 2025
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Spectrum of pulmonary aspergillus diseases in post TB lung diseases
Lovika Lakhtakia1, Sonam Spalgais1, Raj Kumar1
1Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, 110007, India.
Introduction:
Post-Pulmonary TB structural lung disease with cavitation and bronchiectasis favours the growth of Aspergillus. It leads to progressive lung destruction and the persistence of symptoms after successful ATT and can mimic smear-negative PTB. There is lack of prevalence study of this disease from India. Antifungal therapy is very beneficial, as it reduces both morbidity and mortality. The present study is being undertaken to study the occurrence of spectrum of PA in PTBLD.
Methods:
This is a prospective observational study, conducted at one of the tertiary chest institute of India over a period of one year, after approval from institutional human ethics committee. A total of 60 patients with history of treatment for PTB were recruited. Active PTB were excluded. Diagnosis of PA in were established on the basis of clinical, radiological, microbiological and serological parameters. Based on this, the spectrum of PA viz. CPA, ABPA and IPA were established.
Results:
The mean age was 47.88 ± 12.89 years with males being 60%. Mean duration of illness was 6.57 ± 5.11 years with mean asymptomatic period of 4.97 ± 7.41 year. Cough and breathlessness (100%) being the most common symptom followed by wheezing (58%). PA was diagnosed in 48% of cases out of which 43% cases were of CPA. The most common subtype of CPA was simple aspergilloma 14 (54%) followed by CCPA 10 (38%), 2CFPA (8%). ABPA was diagnosed in two cases of PA and one case of aspergillus sensitization. None of the case diagnosed as IPA.
Conclusion:
We found high prevalence of PA among PTBLD, especially CPA. Early recognition and treatment with antifungal has the potential to reduce the morbidity and mortality. There is a need of prospective community-based larger multicentric studies to precisely define the prevalence of these disorders.
Insights
A high prevalence of Aspergillus infection (PA) was found in patients with post-pulmonary tuberculosis lung disease (PTBLD), particularly chronic pulmonary aspergillosis (CPA). Early antifungal treatment can reduce illness and death in these patients.
Area of Science:
- Pulmonology
- Infectious Diseases
- Medical Mycology
Background:
- Structural lung disease post-pulmonary tuberculosis (PTBLD) with cavitation and bronchiectasis promotes Aspergillus growth.
- This can lead to progressive lung destruction and persistent symptoms, mimicking smear-negative PTB.
- Antifungal therapy is crucial for reducing morbidity and mortality in affected individuals.
Purpose of the Study:
- To investigate the occurrence and spectrum of Aspergillus-related lung disease in patients with PTBLD in India.
- To determine the prevalence of different forms of pulmonary aspergillosis (PA) in this population.
Main Methods:
- A prospective observational study was conducted over one year at a tertiary chest institute in India.
- Sixty patients with a history of treated PTB were recruited, excluding those with active PTB.
- Diagnosis of PA was based on clinical, radiological, microbiological, and serological parameters, classifying cases into CPA, ABPA, and IPA.
Main Results:
- Pulmonary aspergillosis (PA) was diagnosed in 48% of patients with PTBLD.
- Chronic pulmonary aspergillosis (CPA) was the most common form (43% of all cases), with simple aspergilloma being the most frequent subtype (54% of CPA).
- Allergic bronchopulmonary aspergillosis (ABPA) was diagnosed in two cases, and aspergillus sensitization in one; no cases of invasive pulmonary aspergillosis (IPA) were identified.
Conclusions:
- A high prevalence of PA, especially CPA, exists among patients with PTBLD.
- Early diagnosis and antifungal treatment are essential for mitigating morbidity and mortality.
- Larger, multicenter, community-based studies are needed to accurately establish the prevalence of these conditions.
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