000 Aspergillosis Chronic Pulmonary Aspergillosis (CPA)

  • Buzz Words
    • colonize
      • cavities in the lungs,
    • aspergillomas may also be present in the lungs.
46 year old immunocompromised male  with a fever.  CT shows small cavitating  right apical spiculated nodule and calcifications in a left apical spiculated nodule . Diagnosis probable Chronic Pulmonary Aspergillosis with Aspergillomas in TB cavities
Ashley Davidoff TheCommonVein.net
CT – Large Biapical Cavities Likely TB in origin with Colonized Aspergillomas 
46 year old immunocompromised male  with a fever.  CT shows small biapical cavitations with internal solid debris  .
Diagnosis probable Chronic Pulmonary Aspergillosis with Aspergillomas in TB cavities
Ashley Davidoff TheCommonVein.net
  • Chronic Pulmonary Aspergillosis (CPA):
    • A long-term fungal infection primarily caused by Aspergillus species in the lungs.
    • Affects individuals with underlying lung conditions like
      • COPD
      • bronchiectasis
      • tuberculosis
    • Generally occurs in people with compromised immune systems or damaged lung tissues.
  • Types of CPA:
    • Chronic Cavitary Pulmonary Aspergillosis (CCPA):
      • Formation of lung cavities with fungal growth.
      • Symptoms: Chronic cough, weight loss, fatigue, coughing up blood.
    • Chronic Fibrosing Pulmonary Aspergillosis (CFPA):
      • Invasive growth leading to lung tissue scarring.
      • Symptoms: Shortness of breath, fatigue, persistent cough.
    • Chronic Necrotizing Pulmonary Aspergillosis (CNPA):
      • Progression from CPA, involving tissue necrosis.
      • Symptoms: Cough, fever, weight loss, chest pain.
  • Diagnosis:
    • Medical history, symptoms, and risk factors assessment.
    • Imaging tests like chest X-rays, CT scans, showing characteristic signs.
    • Laboratory tests including sputum cultures and serological tests.
  • Treatment:
    • Antifungal medications (itraconazole, voriconazole) to control the infection.
    • Prolonged treatment may be needed, often for months to years.
    • Surgical removal considered in specific cases to remove fungal masses.
    • Management of underlying lung conditions and overall health is important.
  • Prognosis:
    • Prognosis varies based on the type of CPA and the patient’s health.
    • Early diagnosis and appropriate treatment improve outcomes.
    • Regular monitoring and follow-up are essential to manage the condition effectively.
  • Prevention:
    • Managing underlying lung diseases and conditions.
    • Minimizing exposure to environmental mold and fungi.
    • Adhering to prescribed treatments and medications.