title: Recent advances in chronic pulmonary aspergillosis.
abstract: Chronic pulmonary aspergillosis (CPA) is a slowly progressing pulmonary syndrome caused by Aspergillus spp. Specific knowledge regarding the disease entity, diagnosis method, and management is needed. This review focuses on the recent advances in our understanding of CPA. A new clinical disease entity of chronic progressive pulmonary aspergillosis consisting of chronic necrotizing pulmonary aspergillosis and chronic cavitary pulmonary aspergillosis is proposed. Although newer antifungals are not available, evidence describing the treatment of CPA is accumulating. Longer administration of azoles is required for a better prognosis, but there is a risk of inducing azole resistance. Therapeutic drug monitoring and patient education are required. Establishing a drug-susceptibility test that can be performed in the general laboratory and the referral center are also important. Although the number of publications regarding CPA is growing, there are still many unanswered questions. Additional evidence and translational research regarding diagnosis, management, and drug resistance are urgently needed to improve the outcome of CPA.
authors.affiliation: Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. Electronic address: koizumik@nagasaki-u.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Izumikawa
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001230:Aspergillus / Q000187:drug effects; D001393:Azoles / Q000008:administration & dosage* / Q000494:pharmacology; D002908:Chronic Disease; D018450:Disease Progression; D016903:Drug Monitoring; D025141:Drug Resistance, Fungal; D019317:Evidence-Based Medicine; D006801:Humans; D008826:Microbial Sensitivity Tests; D010353:Patient Education as Topic; D011379:Prognosis; D055732:Pulmonary Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D012306:Risk; D057170:Translational Research, Biomedical / Q000639:trends
chemical_list: D000935:Antifungal Agents; D001393:Azoles
keywords: Aspergilloma; Azole resistance; CCPA; CNPA; CPP