a National Aspergillosis Centre, Manchester Academic Health Science Centre , University Hospital of South Manchester, University of Manchester , Manchester , UK.
Infect Dis (Lond). 2017 Apr;49(4):296-301. doi: 10.1080/23744235.2016.1232861. Epub 2016 Sep 23.
Chronic pulmonary aspergillosis (CPA) has substantial impact on quality of life. A subset of patients develops significant pulmonary fibrosis, identified either on biopsy or radiologically. The term chronic fibrosing pulmonary aspergillosis (CFPA) has been suggested.
We describe 11 patients with CFPA referred to our centre.
Mean age was 58.5 years and five were male. In nine, fibrosis was already evident on presentation, while in two it developed 3 and 6 years later. The predominant radiological feature was extensive or complete involvement of the entire lung, with minimal contralateral involvement. All patients received prolonged antifungal treatment. Two patients had surgical treatment; both developed post-operative complications. The contralateral lung remained free of significant disease in all but three patients.
CFPA is a rare complication of CPA that is usually evident on presentation, but may develop after years in patients not on antifungals. Fibrosis resembles the 'destroyed lung' syndrome described after treated tuberculosis.
慢性肺曲霉病（CPA）对生活质量有重大影响。一部分患者会出现明显的肺纤维化，这可通过活检或影像学检查来确定。因此，有人提出了慢性纤维性肺曲霉病（CFPA）这一术语。
我们描述了 11 例被转诊至我们中心的 CFPA 患者。
平均年龄为 58.5 岁，男性 5 例。9 例患者在就诊时已有纤维化，而另外 2 例则分别在 3 年和 6 年后出现纤维化。主要的影像学特征是整个肺部广泛或完全受累，对侧受累较少。所有患者均接受了长期抗真菌治疗。2 例患者接受了手术治疗，但均出现术后并发症。除 3 例患者外，对侧肺部均未出现明显疾病。
CFPA 是 CPA 的罕见并发症，通常在就诊时即可发现，但在未接受抗真菌治疗的患者中，可能在数年后才出现。纤维化类似于治疗后肺结核后描述的“破坏肺”综合征。
