title: Clinical characteristics and prognosis of chronic pulmonary aspergillosis.
abstract: BACKGROUND
  The details of the clinical characteristics of patients with chronic pulmonary aspergillosis (CPA) have not been fully understood.
  
  
  METHODS
  One hundred twenty-nine consecutive patients with isolation of Aspergillus species by culture from respiratory specimens who attended our hospital between October 2001 and September 2009 were enrolled. Patients diagnosed with chronic pulmonary aspergillosis (CPA) were retrospectively reviewed for clinical characteristics and prognosis, compared with patients with Aspergillus species colonization.
  
  
  RESULTS
  Forty-two (32.6%) were diagnosed with CPA, whereas 87 (67.4%) with colonization. Aspergillus fumigatus was significantly more frequently detected in the CPA group than in the colonization group. Regarding underlying diseases, CPA patients had a significantly higher prevalence of a history of pulmonary tuberculosis and diabetes mellitus than colonization patients. There were no significant differences between the CPA and colonization group in Aspergillus antigen titers. Positivity for Aspergillus precipitating antibody was 74.3% in CPA and 15.8% in colonization, respectively. Sensitivity and specificity of Aspergillus precipitating antibody for the determination of CPA was 74.4% and 84.1%, respectively.Patients with CPA had significantly shorter survival than patients with colonization (mortality rate 50.0% vs. 13.8%, observation periods: 28.7 ± 26.6 months) (p < 0.0001). Multivariable analysis revealed that BMI was an independent predictor of prognosis (Odds Ratio, 1.973; p = 0.0223).
  
  
  CONCLUSIONS
  CPA is a disease with a poor prognosis, which shows distinct clinical characteristics from colonization.
authors.affiliation: Department of Respiratory Medicine, Tenryu Hospital, National Hospital Organization, 4201-2, Hamamatsu 434-8511, Japan.
authors.forename: Hisano
authors.initials: H
authors.lastname: Ohba
authors.forename: Seiichi
authors.initials: S
authors.lastname: Miwa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shirai
authors.forename: Miho
authors.initials: M
authors.lastname: Kanai
authors.forename: Tatsuru
authors.initials: T
authors.lastname: Eifuku
authors.forename: Takafumi
authors.initials: T
authors.lastname: Suda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hayakawa
authors.forename: Kingo
authors.initials: K
authors.lastname: Chida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000908:Antibodies, Fungal / Q000097:blood; D000946:Antigens, Fungal / Q000097:blood; D001230:Aspergillus / Q000145:classification / Q000276:immunology / Q000302:isolation & purification; D015992:Body Mass Index; D002908:Chronic Disease; D005260:Female; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis / Q000382:microbiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055732:Pulmonary Aspergillosis / Q000175:diagnosis* / Q000382:microbiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal