Clinical characteristics and treatment outcomes of chronic pulmonary aspergillosis in Bahawalpur: a gender-based observational study

Abstract Background Chronic pulmonary aspergillosis (CPA) is a rare fungal disease caused by Aspergillus species. The aim of this study was to evaluate the treatment outcomes of anti-fungal therapy among CPA patients according to CPA-net consensus definitions. Moreover, we also aimed to report sociodemographic and clinical parameters of the patients through gender lens. Methods This was a descriptive, cross-sectional study carried out in the Chest Disease Unit of the Bahawal Victoria hospital, Bahawalpur, Pakistan, and a private chest clinic from March, 2024 to July, 2025. All patients who were confirmed as CPA cases and consented to participate in the study were enrolled. CPA-net consensus statement was used as a reference for assessing the treatment outcomes. Results A total of 55 patients were registered during the study period, with a mean age of 44.8 ± 18.6 years. The study identified TB as the primary underlying cause of CPA (80%; n = 44), with post-TB CPA being the most common form. Most of the patients had isolates of both Aspergillus fumigatus and Aspergillus flavus in their samples (85.5%; n = 47). After treatment, 41.8% ( n = 23) of the patients showed improvement; however, 34.5% ( n = 19) of the patients died during study period and 7.3% ( n = 4) had treatment failure. The treatment outcomes among CPA patients were significantly associated with use of intravenous steroids ( p = 0.033) and presence of hemoptysis at the baseline ( p = 0.04). Conclusion Among the patients, post-TB CPA was most prevalent form. Despite the high mortality, a significant proportion of patients responded positively to voriconazole. Gender was not associated with treatment success rate; however, treatment deterioration and loss to follow-up were relatively more common among the male patients.