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Updated: Jun 9, 2025
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Three-Month Mortality in Nonhaematological Patients with Chronic Pulmonary Aspergillosis: Differences between
Pablo González García1, Julia Fernández-Navarro2, Mónica Bru-Arca3
1Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Universidad de Cantabria, 39008 Santander, Spain.
Abstract:
Objectives: Chronic pulmonary aspergillosis (CPA) is a fungal lung infection characterised by the slowly progressing destruction of the lung parenchyma and has four main subtypes. The objective of this work was to evaluate the epidemiology of CPA in our area and evaluate the involvement of the different subtypes in mortality. Methods: This was a descriptive longitudinal retrospective study developed in three tertiary hospitals in Spain. Among all patients admitted with a pulmonary aspergillosis diagnosis, we selected those who fulfilled the criteria for chronic aspergillosis according to the criteria of Denning, excluding those with a haematological disorder. Results: Among 409 inpatients recorded as having a pulmonary aspergillosis infection, only 76 (18.5%) fulfilled the criteria for CPA, with an estimated incidence of 0.67 cases/100,000 inhabitants/year. The subtypes detected were subacute invasive aspergillosis (SAIA) in 33 (43.4%) patients, simple aspergilloma (SA) in 25 (32.9%) patients, cavitary chronic aspergillosis (CCPA) in 13 (17.1%) patients, and chronic fibrosis (CFPA) in five (6.5%) patients. The overall three-month mortality rate was 23%, which was higher in SAIA patients. The predictors of early mortality were age > 65 years (OR 3.0 CI 95 1.0-9.5 p = 0.043) and the SAIA subtype vs. other subtypes (OR 3.1 CI 95 1.0-9.5 p = 0.042). Conclusions: The incidence rate estimated was inferior to that previously reported. The three-month mortality in patients with CPA was high, with older age and the SAIA subtype being the variable independent predictors of a worse prognosis.
Insights
Chronic pulmonary aspergillosis (CPA) has a lower incidence than previously reported. Older age and subacute invasive aspergillosis (SAIA) are key predictors of early mortality in CPA patients.
Area of Science:
- Pulmonology
- Infectious Diseases
- Epidemiology
Background:
- Chronic pulmonary aspergillosis (CPA) is a progressive fungal lung infection with distinct subtypes.
- Understanding CPA epidemiology and subtype-specific mortality is crucial for patient management.
Purpose of the Study:
- To evaluate the epidemiology of CPA in a Spanish tertiary hospital setting.
- To assess the impact of different CPA subtypes on patient mortality.
Main Methods:
- A retrospective longitudinal study of pulmonary aspergillosis patients in three Spanish tertiary hospitals.
- Inclusion criteria followed Denning's criteria for CPA, excluding patients with hematological disorders.
Main Results:
- An incidence of 0.67 cases/100,000 inhabitants/year was estimated for CPA.
- Subacute invasive aspergillosis (SAIA) was the most frequent subtype (43.4%), followed by simple aspergilloma (32.9%).
- The three-month mortality rate was 23%, significantly higher in SAIA patients. Age > 65 and SAIA were independent predictors of mortality.
Conclusions:
- The estimated CPA incidence is lower than previously reported in other regions.
- CPA presents a high three-month mortality rate.
- Advanced age and the SAIA subtype are significant independent predictors of a poorer prognosis in CPA.
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