Case Definition of Chronic Pulmonary Aspergillosis in Resource-Constrained Settings

David W Denning, Iain D Page, Jeremiah Chakaya, Kauser Jabeen, Cecilia M Jude, Muriel Cornet, Ana Alastruey-Izquierdo, Felix Bongomin, Paul Bowyer, Arunaloke Chakrabarti, Sara Gago, John Guto, Bruno Hochhegger, Martin Hoenigl, Muhammad Irfan, Nicholas Irurhe, Koichi Izumikawa, Bruce Kirenga, Veronica Manduku, Samihah MoazamRita O Oladele, Malcolm D Richardson, Juan Luis Rodriguez Tudela, Anna Rozaliyani, Helmut J F Salzer, Richard Sawyer, Nasilele F Simukulwa, Alena Skrahina, Charlotte Sriruttan, Findra Setianingrum, Bayu A P Wilopo, Donald C Cole, Haileyesus Getahun

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Chronic pulmonary aspergillosis (CPA) is a recognized complication of pulmonary tuberculosis (TB). In 2015, the World Health Organization reported 2.2 million new cases of nonbacteriologically confirmed pulmonary TB; some of these patients probably had undiagnosed CPA. In October 2016, the Global Action Fund for Fungal Infections convened an international expert panel to develop a case definition of CPA for resource-constrained settings. This panel defined CPA as illness for >3 months and all of the following: 1) weight loss, persistent cough, and/or hemoptysis; 2) chest images showing progressive cavitary infiltrates and/or a fungal ball and/or pericavitary fibrosis or infiltrates or pleural thickening; and 3) a positive Aspergillus IgG assay result or other evidence of Aspergillus infection. The proposed definition will facilitate advancements in research, practice, and policy in lower- and middle-income countries as well as in resource-constrained settings.

Original languageEnglish
Number of pages35
JournalEmerging infectious diseases
Issue number8
Early online date17 Jul 2018
Publication statusPublished - Aug 2018


  • Aspergillosis/*diagnosis/*pathology


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