Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 10 , ISSUE 2 ( May-August, 2021 ) > List of Articles


Chronic Pulmonary Aspergillosis - Case Series and Review of Indian Literature

Robin Choudhary, Deepu K. Peter, Gaurav Bhati, Kunal Kumar, R Akhil, Shafin Babu

Keywords : Aspergillus-specific IgG, chronic pulmonary aspergillosis, voriconazole

Citation Information : Choudhary R, Peter DK, Bhati G, Kumar K, Akhil R, Babu S. Chronic Pulmonary Aspergillosis - Case Series and Review of Indian Literature. Indian J Respir Care 2021; 10 (2):230-235.

DOI: 10.4103/ijrc.ijrc_98_20

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2021; Indian Journal of Respiratory Care.


Aspergillus species, especially Aspergillus fumigatus, can cause varied pulmonary manifestations depending on the host immune status and duration of infection. Chronic pulmonary aspergillosis (CPA) is an under-reported entity, and its diagnosis remains a diagnostic challenge for clinicians. CPA can have varied presentations including chronic cavitary pulmonary aspergillosis (CCPA), subacute invasive pulmonary aspergillosis, and chronic fibrosing pulmonary aspergillosis. Underlying lung diseases such as chronic obstructive pulmonary disease and sequelae of pulmonary tuberculosis predisposes these individuals to CPA. These cases can present as chronic cough with hemoptysis even requiring emergency bronchial artery embolization. Here, we present a series of four CCPA cases who were diagnosed on the basis of clinico-radiological features and the Aspergillus-specific IgG antibody levels. A review of case series published in India is also presented.

  1. Denning DW. Invasive aspergillosis. Clin Infect Dis 1998;26:781-803.
  2. Denning DW, Riniotis K, Dobrashian R, Sambatakou H. Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: Case series, proposed nomenclature change, and review. Clin Infect Dis 2003;37 Suppl 3:S265-80.
  3. Hope WW, Walsh TJ, Denning DW. The invasive and saprophytic syndromes due to Aspergillus spp. Med Mycol 2005;43 Suppl 1:S207-38.
  4. Smith NL, Denning DW. Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma. Eur Respir J 2011;37:865-72.
  5. Binder RE, Faling LJ, Pugatch RD, Mahasaen C, Snider GL. Chronic necrotizing pulmonary aspergillosis: A discrete clinical entity. Medicine (Baltimore) 1982;61:109-24.
  6. Miller WT Jr., Sais GJ, Frank I, Gefter WB, Aronchick JM, Miller WT. Pulmonary aspergillosis in patients with AIDS. Clinical and radiographic correlations. Chest 1994;105:37-44.
  7. Pasqualotto AC, Denning DW. An aspergilloma caused by Aspergillus flavus. Med Mycol 2008;46:275-8.
  8. Severo LC, Geyer GR, Porto Nda S, Wagner MB, Londero AT. Pulmonary Aspergillus Niger intracavitary colonization. Report of 23 cases and a review of the literature. Rev Iberoam Micol 1997;14:104-10.
  9. Denning DW. Chronic forms of pulmonary aspergillosis. Clin Microbiol Infect 2001;7:25-31.
  10. Denning DW, Cadranel J, Beigelman-Aubry C, Ader F, Chakrabarti A, Blot S, et al. Chronic pulmonary aspergillosis: Rationale and clinical guidelines for diagnosis and management. Eur Respir J 2016;47:45-68.
  11. Kosmidis C, Denning DW. The clinical spectrum of pulmonary aspergillosis. Thorax 2015;70:270-7.
  12. Pai Jakribettu R, George T, Abraham S, Fazal F, Kinila S, Baliga MS. Clinical and laboratory profile of chronic pulmonary aspergillosis: A retrospective study. Egypt J Bronchol 2019;13:109-13.
  13. Takazono T, Izumikawa K. Recent advances in diagnosing chronic pulmonary aspergillosis. Front Microbiol 2018;9:1810.
  14. Sehgal I, Choudhary H, Dhooria S, Agarwal A, Garg M, Chakrabarti A, et al. Is there an overlap in immune response between allergic bronchopulmonary and chronic pulmonary aspergillosis? J Allergy Clin Immunol 2018;7:969-74.
  15. Sehgal IS, Choudhary H, Dhooria S, Aggarwal AN, Garg M, Chakrabarti A, et al. Diagnostic cut-off of Aspergillus fumigatus-specific IgG in the diagnosis of chronic pulmonary aspergillosis. Mycoses 2018;61:770-6.
  16. Chawla K, Kosaraju K, Rayasam S, Mukhopadhyay C. Clinico-microbiological profile of chronic pulmonary aspergillosis from a tertiary care centre in southern India. J Clin Diagn Res 2013;7:2712-5.
  17. Agarwal R, Vishwanath G, Aggarwal AN, Garg M, Gupta D, Chakrabarti A. Itraconazole in chronic cavitary pulmonary aspergillosis: A randomised controlled trial and systematic review of literature. Mycoses 2013;56:559-70.
  18. Kurhade AM, Deshmukh JM, Fule RP, Chande C, Akulwar S. Mycological and serological study of pulmonary aspergillosis in central India. Indian J Med Microbiol 2002;20:141-4.
  19. Shahid M, Malik A, Bhargava R. Prevalence of aspergillosis in chronic lung diseases. Indian J Med Microbiol 2001;19:201-5.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.