title: Prevalence of chronic pulmonary aspergillosis in patients with tuberculosis from Iran.
abstract: In patients with preexisting lung disease, especially a cavity, Aspergillus can infect the surface of the cavity, causing chronic cavitary pulmonary aspergillosis (CCPA), and may form an aspergilloma, collectively called chronic pulmonary aspergillosis (CPA). In the present study, we assessed tuberculosis (TB) patients for CPA based on culture and serological methods. During a period of 1 year (from March 2013 to March 2014), we studied 124 patients with TB (94 with current TB and 30 with previous TB) at Masih Daneshvari Hospital in Tehran, Iran. Sputum specimens were analyzed by direct microscopic examination (DME) and fungal culture. The clinical and radiological features of all patients were recorded, to categorize the patients into CCPA and aspergilloma. All patients were screened for serum-specific IgG against A. fumigatus, by enzyme-linked immunosorbent assay (ELISA). Out of 124 patients with TB (66 male, age range: 10-91 years), 48 patients (38.7 %) exhibited residual cavities. Eighteen (14.5 %) patients had cavities with pleural thickening. A round-shaped mass lesion was detected in six patients (6.8 %). DME was positive in ten patients for septate fungal hyphae. A. fumigatus was grown from 14 samples. Fifty-five (44.3 %) cases were positive for serum-specific IgG against A. fumigatus. Of 124 patients with TB, 3 (2.4 %) met criteria for aspergilloma and 14 (11.3 %) for CCPA. CPA is a common clinical presentation in individuals with healed TB in Iran, as reported by previous studies from other countries.
authors.affiliation: Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Km 18 Khazarabad Road, P.O. Box 48175-1665, Sari, Iran, hedayatimt@gmail.com.
authors.forename: M T
authors.initials: MT
authors.lastname: Hedayati
authors.forename: Y
authors.initials: Y
authors.lastname: Azimi
authors.forename: A
authors.initials: A
authors.lastname: Droudinia
authors.forename: B
authors.initials: B
authors.lastname: Mousavi
authors.forename: A
authors.initials: A
authors.lastname: Khalilian
authors.forename: N
authors.initials: N
authors.lastname: Hedayati
authors.forename: D W
authors.initials: DW
authors.lastname: Denning
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000908:Antibodies, Fungal / Q000097:blood; D001232:Aspergillus fumigatus / Q000276:immunology / Q000302:isolation & purification*; D001999:Bronchoscopy; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007492:Iran / Q000453:epidemiology; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000150:complications; D055815:Young Adult
chemical_list: D000908:Antibodies, Fungal; D007074:Immunoglobulin G