Clinical characteristics and treatment outcomes of chronic pulmonary aspergillosis

Chronic pulmonary aspergillosis (CPA) is a relatively uncommon disease that has been poorly characterized. This study investigated the clinical features and treatment outcomes of CPA through a retrospective review of records of patients with newly diagnosed CPA between January 2008 and January 2012. A total of 70 CPA patients, which included 51 (73%) males, had a median age of 55 years. Fifty-seven patients (81%) had a history of pulmonary tuberculosis and pulmonary disease caused by nontuberculous mycobacteria (NTM) was a primary underlying condition in 32 patients (46%). Most patients (n = 66; 99%) were treated with oral itraconazole, for a median of 6.4 months. Treatment response of 73% of patients was based on alleviation of symptoms and in 44% on computed tomography. Laboratory tests improved for more than 60% of patients and overall favorable responses were achieved in 44 patients (62%). Five of the latter (11%) had to restart antifungal therapy after a median of 9.2 months after therapy. Death occurred in 10 patients (14%). This study suggested that NTM lung disease was an important risk factor for CPA development. While treatment with oral itraconazole for approximately 6 months was moderately effective in treating CPA, a more effective treatment is required.