Clinical presentation, risk factors and outcomes in chronic pulmonary aspergillosis: evidences from a tertiary care hospital

Chronic pulmonary aspergillosis (CPA) is increasingly recognized among patients with chronic pulmonary diseases. <bold>Aim:</bold> To investigate risk factors, clinical and paraclinical features, and their association with outcomes in patients with CPA. <bold>Methods:</bold> Twenty-seven CPA patients (mean age 54.37±13.35 years, 67% men) were enrolled from 2014 to 2019 and followed up for 36 months. <bold>Results:</bold> Chronic fibrosing pulmonary aspergillosis was the most common type of CPA (63%), followed by chronic cavitary pulmonary aspergillosis (22%) and simple aspergilloma (11%). Underlying pulmonary conditions were diverse, with post-tuberculosis sequelae being most prevalent (11/27 cases). Seven patients (27%) had a BMI less than 18.5 kg/m², and hemoptysis was reported in 18 patients (67%). Fungus ball was observed in 18 cases. Univariate analysis identified pulmonary tuberculosis (OR 2.88; 95%CI 1.29-6.45; p=0.01) and the presence of cystic bronchiectasis or cavities (OR 5.4; 95%CI 2-14.53; p=0.0001) as risk factors for CPA. Over the 36-month follow-up, CPA patients exhibited a high mortality rate (37%). <bold>Conclusion:</bold> A correlation between chronic pulmonary aspergillosis (CPA) and a history of pulmonary tuberculosis was evident in the majority of cases, with a notable increase in mortality rates.