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Case Definition of Chronic Pulmonary Aspergillosis in Resource-Constrained Settings.

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

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.

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