Clinical Features, Diagnostic Test Performance, and Prognosis in Different Subtypes of Chronic Pulmonary Aspergillosis

作者：Huanhuan Zhong, Yaru Wang, Yu Gu, Yueyan Ni, Yu Wang, Kunlu Shen, Yi Shi, Xin Su · 发表于：Frontiers in Medicine · 年份：2022 · DOI：10.3389/fmed.2022.811807 · 被引用次数：23 · 研究领域：Antifungal resistance and susceptibility、Infectious Diseases and Mycology、Fungal Infections and Studies

Objective The aim of this study was to describe clinical features in different subtypes of chronic pulmonary aspergillosis (CPA)-simple aspergilloma (SA), chronic cavitary pulmonary aspergillosis (CCPA), chronic fibrosing pulmonary aspergillosis (CFPA), aspergillus nodule (AN), and subacute invasive aspergillosis (SAIA), respectively, and identify long-term prognosis of CPA. Methods We reviewed patients diagnosed with different subtypes of CPA from 2002 to 2020 at Nanjing Jinling Hospital, China. We analyzed the clinical and survival information of five different subgroups. A Cox regression model was used to explore proper antifungal duration and long-term survival factors of CCPA and SAIA. Results A total of 147 patients with CPA were included, consisting of 11 SA, 48 CCPA, 5 CFPA, 12 AN, and 71 SAIA. The most common underlying pulmonary disease was pulmonary tuberculosis ( n = 49, 33%), followed by bronchiectasis ( n = 46, 31.3%) and chronic obstructive pulmonary disease (COPD) or emphysema ( n = 45, 30.6%), while in SAIA and CFPA groups, the most common was COPD or emphysema (45.1 and 100%). Cough (85%), expectoration (70.7%), hemoptysis (54.4%), and fever (29.9%) were common symptoms, especially in CCPA, CFPA, and SAIA groups. The common imaging manifestations included cavitation ( n = 94, 63.9%), fungal ball ( n = 54, 36.7%), pleural thickening ( n = 47, 32.0%), and bronchiectasis ( n = 46, 31.3%). SAIA and CFPA groups had a lower value of hemoglobin (HB) and serum album...