Chronic fibrosing pulmonary aspergillosis: a cause of 'destroyed lung' syndrome

Chris Kosmidis; Pippa Newton; Eavan G Muldoon; David W Denning

doi:10.1080/23744235.2016.1232861

Chronic fibrosing pulmonary aspergillosis: a cause of 'destroyed lung' syndrome

Chris Kosmidis, Pippa Newton, Eavan G Muldoon, David W Denning

Division of Immunology, Immunity to Infection and Respiratory Medicine

University Hospital of South Manchester NHS Foundation Trust

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: 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.

METHODS: We describe 11 patients with CFPA referred to our centre.

RESULTS: 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.

CONCLUSIONS: 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.

Original language	English
Pages (from-to)	296-301
Number of pages	6
Journal	Infectious diseases
Volume	49
Issue number	4
Early online date	23 Sept 2016
DOIs	https://doi.org/10.1080/23744235.2016.1232861
Publication status	Published - Apr 2017

Keywords

Adult
Aged
Chronic Disease
Female
Fibrosis/diagnostic imaging
Humans
Lung/diagnostic imaging
Male
Middle Aged
Pulmonary Aspergillosis/complications
Radiography, Thoracic
Retrospective Studies
Tomography, X-Ray Computed

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/23744235.2016.1232861

MFIG: Manchester Fungal Infection Group (MFIG)
Bromley, M., Bertuzzi, M., Gago, S., Denning, D., Kosmidis, C., Bowyer, P., Amich Elias, J., Richardson, M. & Richardson, R.
15/08/13 → …
Project: Research

Cite this

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title = "Chronic fibrosing pulmonary aspergillosis: a cause of 'destroyed lung' syndrome",

abstract = "BACKGROUND: 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.METHODS: We describe 11 patients with CFPA referred to our centre.RESULTS: 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.CONCLUSIONS: 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.",

keywords = "Adult, Aged, Chronic Disease, Female, Fibrosis/diagnostic imaging, Humans, Lung/diagnostic imaging, Male, Middle Aged, Pulmonary Aspergillosis/complications, Radiography, Thoracic, Retrospective Studies, Tomography, X-Ray Computed",

author = "Chris Kosmidis and Pippa Newton and Muldoon, {Eavan G} and Denning, {David W}",

year = "2017",

month = apr,

doi = "10.1080/23744235.2016.1232861",

language = "English",

volume = "49",

pages = "296--301",

journal = "Infectious diseases",

issn = "2374-4235",

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TY - JOUR

T1 - Chronic fibrosing pulmonary aspergillosis

T2 - a cause of 'destroyed lung' syndrome

AU - Kosmidis, Chris

AU - Newton, Pippa

AU - Muldoon, Eavan G

AU - Denning, David W

PY - 2017/4

Y1 - 2017/4

N2 - BACKGROUND: 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.METHODS: We describe 11 patients with CFPA referred to our centre.RESULTS: 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.CONCLUSIONS: 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.

AB - BACKGROUND: 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.METHODS: We describe 11 patients with CFPA referred to our centre.RESULTS: 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.CONCLUSIONS: 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.

KW - Adult

KW - Aged

KW - Chronic Disease

KW - Female

KW - Fibrosis/diagnostic imaging

KW - Humans

KW - Lung/diagnostic imaging

KW - Male

KW - Middle Aged

KW - Pulmonary Aspergillosis/complications

KW - Radiography, Thoracic

KW - Retrospective Studies

KW - Tomography, X-Ray Computed

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DO - 10.1080/23744235.2016.1232861

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SN - 2374-4235

VL - 49

SP - 296

EP - 301

JO - Infectious diseases

JF - Infectious diseases

IS - 4

ER -

Chronic fibrosing pulmonary aspergillosis: a cause of 'destroyed lung' syndrome

Abstract

Keywords

UN SDGs

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Projects

MFIG: Manchester Fungal Infection Group (MFIG)

Cite this