Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi - 110030, India.
Department of Pulmonary Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.
Indian J Tuberc. 2023 Jul;70(3):276-285. doi: 10.1016/j.ijtb.2023.03.014. Epub 2023 Apr 1.
The disease chronic pulmonary aspergillosis (CPA), which has 3 million cases globally, has a substantial impact on global health. The morbidity and mortality it cause are also rather severe. Patients with modest immune suppression or those with underlying structural and chronic lung illnesses are more likely to develop this condition. CPA pose a diagnostic and management challenge to clinicians. The condition causes patients to have persistent respiratory difficulties, which lowers their quality of life, and the therapy is lengthy and offers few choices. Particularly in a nation like India, where tuberculosis (TB) is prevalent and patients exhibit identical signs and symptoms, a strong index of suspicion is required. Treated pulmonary TB patients, presenting with symptoms or chest x-ray abnormalities, especially those with presence of cavity are also more prone to develop CPA. The constellation of symptoms together with presence of microbiological criteria and suggestive radiology can help to reach at the diagnosis. The field of mycology has made major developments, but there is still much to understand about this illness and to establish timely diagnoses and make the best use of the existing treatment choices. The burden of CPA in patients with treated TB is highlighted in this article along with the most recent research and clinical guidelines.
疾病慢性肺曲霉病(CPA),全球有 300 万例,对全球健康有重大影响。它引起的发病率和死亡率也相当严重。免疫抑制程度较轻的患者或患有潜在结构性和慢性肺部疾病的患者更有可能患上这种疾病。CPA 给临床医生的诊断和管理带来了挑战。这种疾病导致患者持续呼吸困难,降低了他们的生活质量,而且治疗时间长,选择有限。特别是在印度这样的国家,结核病(TB)很普遍,患者表现出相同的症状和体征,因此需要强烈的怀疑指数。有症状或胸部 X 线异常的治疗后肺结核患者,特别是有空腔存在的患者,也更容易发展为 CPA。症状的组合以及存在微生物学标准和提示性影像学可以帮助做出诊断。真菌学领域取得了重大进展,但仍有许多关于这种疾病的知识需要了解,以便及时诊断,并充分利用现有的治疗选择。本文强调了治疗后 TB 患者中 CPA 的负担,以及最新的研究和临床指南。