Emerging Infectious Diseases (Aug 2018)

Case Definition of Chronic Pulmonary Aspergillosis in Resource-Constrained Settings

  • David W. Denning,
  • Iain D. Page,
  • Jeremiah Chakaya,
  • Kauser Jabeen,
  • Cecilia M. Jude,
  • Muriel Cornet,
  • Ana Alastruey-Izquierdo,
  • Felix Bongomin,
  • Paul Bowyer,
  • Arunaloke Chakrabarti,
  • Sara Gago,
  • John Guto,
  • Bruno Hochhegger,
  • Martin Hoenigl,
  • Muhammad Irfan,
  • Nicholas Irurhe,
  • Koichi Izumikawa,
  • Bruce Kirenga,
  • Veronica Manduku,
  • Samihah Moazam,
  • Rita O. Oladele,
  • Malcolm D. Richardson,
  • Juan Luis Rodriguez Tudela,
  • Anna Rozaliyani,
  • Helmut J.F. Salzer,
  • Richard Sawyer,
  • Nasilele F. Simukulwa,
  • Alena Skrahina,
  • Charlotte Sriruttan,
  • Findra Setianingrum,
  • Bayu A.P. Wilopo,
  • Donald C. Cole,
  • Haileyesus Getahun

DOI
https://doi.org/10.3201/eid2408.171312
Journal volume & issue
Vol. 24, no. 8

Abstract

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Chronic pulmonary aspergillosis (CPA) is a recognized complication of pulmonary tuberculosis (TB). In 2015, the World Health Organization reported 2.2 million new cases of nonbacteriologically confirmed pulmonary TB; some of these patients probably had undiagnosed CPA. In October 2016, the Global Action Fund for Fungal Infections convened an international expert panel to develop a case definition of CPA for resource-constrained settings. This panel defined CPA as illness for >3 months and all of the following: 1) weight loss, persistent cough, and/or hemoptysis; 2) chest images showing progressive cavitary infiltrates and/or a fungal ball and/or pericavitary fibrosis or infiltrates or pleural thickening; and 3) a positive Aspergillus IgG assay result or other evidence of Aspergillus infection. The proposed definition will facilitate advancements in research, practice, and policy in lower- and middle-income countries as well as in resource-constrained settings.

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