Main Article Content
Abstract
BACKGROUND
Pulmonary aspergillosis represents a significant cause of pulmonary infection, particularly in post-tuberculosis patients. The similarity of its clinical presentation to tuberculosis often leads to diagnostic delays, increasing morbidity and mortality.
METHODS
This cross-sectional descriptive study was conducted in the Department of Radiodiagnosis, Assam Medical College and Hospital, Dibrugarh, from March 2023 to February 2024. A total of 150 patients with clinical or imaging suspicion of pulmonary aspergillosis underwent HRCT (High-Resolution Computed Tomography). Findings were correlated with microbiological results for confirmation.
RESULTS
The study population predominantly comprised males (70%), with the most affected age groups being 36–45 years and 46–55 years (24% each). The most common symptoms were cough (62.7%) and haemoptysis (54%). A significant association was observed between previous tuberculosis and aspergillosis (p < 0.001). HRCT findings showed bronchiectasis (72%), fibrosis (64.7%), fungal balls (52%), and cavitary lesions (40%) as the dominant features. Upper lobes were most frequently involved, with cavitary lesions being significantly associated with aspergillosis (p < 0.001).
CONCLUSIONS
HRCT serves as an essential non-invasive imaging modality for early detection and characterization of pulmonary aspergillosis, especially in regions with limited microbiological facilities. Recognition of characteristic imaging patterns can guide timely management and reduce misdiagnosis.
Keywords
Article Details
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References
- Di Mango AL, Zanetti G, Penha D, et al. Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging. Expert Rev Respir Med 2019;13(3):263-77.
- Bongomin F, Gago S, Oladele RO, et al. Global and multi-national prevalence of fungal diseases-estimate precision. J Fungi Basel Switz 2017;3(4):57.
- Ekeng BE, Davies AA, Osaigbovo II, et al. Pulmonary and extra pulmonary manifestations of fungal infections misdiagnosed as tuberculosis: the need for prompt diagnosis and management. J Fungi Basel Switz 2022;8(5):460.
- Oladele RO, Ekeng BE, Mandengue CE. Disseminated histoplasmosis; a threat in advanced HIV disease population in sub-Saharan Africa? J Adv Med Med Res 2021;33(3):115-44.
- Houben RMGJ, Lalli M, Kranzer K, et al. What if they don’t have tuberculosis? The consequences and trade-offs involved in false-positive diagnoses of tuberculosis. Clin Infect Dis Off Publ Infect Dis Soc Am 2019;68(1):150-6.
- Prasad A, Agarwal K, Deepak D, et al. Pulmonary aspergillosis: what CT can offer before it is too late! J Clin Diagn Res JCDR 2016;10(4):TE01-5.
- Lewis RE, Stanzani M, Morana G, et al. Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress? Curr Opin Infect Dis 2023;36(4):250-6.
- Kang M, Deoghuria D, Varma S, et al. Role of HRCT in detection and characterization of pulmonary abnormalities in patients with febrile neutropenia. Lung India Off Organ Indian Chest Soc 2013;30(2):124-30.
- Nguyen NTB, Le Ngoc H, Nguyen NV, et al. Chronic pulmonary aspergillosis situation among post tuberculosis patients in vietnam: an observational study. J Fungi Basel Switz 2021;7(7):532.
- Zhong H, Wang Y, Gu Y, et al. Clinical features, diagnostic test performance, and prognosis in different subtypes of chronic pulmonary aspergillosis. Front Med 2022;9:811807.
- Rajpurohit R, Wagh P, Heda M, et al. Prevalence of chronic pulmonary aspergillosis in fibrocavitary pulmonary tuberculosis patients. J Fam Med Prim Care 2023;12(1):106-110.
- Lakhtakia L, Spalgais S, Kumar R. Spectrum of pulmonary aspergillus diseases in post TB lung diseases. Indian J Tuberc 2022;69(4):523-9.
References
Di Mango AL, Zanetti G, Penha D, et al. Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging. Expert Rev Respir Med 2019;13(3):263-77.
Bongomin F, Gago S, Oladele RO, et al. Global and multi-national prevalence of fungal diseases-estimate precision. J Fungi Basel Switz 2017;3(4):57.
Ekeng BE, Davies AA, Osaigbovo II, et al. Pulmonary and extra pulmonary manifestations of fungal infections misdiagnosed as tuberculosis: the need for prompt diagnosis and management. J Fungi Basel Switz 2022;8(5):460.
Oladele RO, Ekeng BE, Mandengue CE. Disseminated histoplasmosis; a threat in advanced HIV disease population in sub-Saharan Africa? J Adv Med Med Res 2021;33(3):115-44.
Houben RMGJ, Lalli M, Kranzer K, et al. What if they don’t have tuberculosis? The consequences and trade-offs involved in false-positive diagnoses of tuberculosis. Clin Infect Dis Off Publ Infect Dis Soc Am 2019;68(1):150-6.
Prasad A, Agarwal K, Deepak D, et al. Pulmonary aspergillosis: what CT can offer before it is too late! J Clin Diagn Res JCDR 2016;10(4):TE01-5.
Lewis RE, Stanzani M, Morana G, et al. Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress? Curr Opin Infect Dis 2023;36(4):250-6.
Kang M, Deoghuria D, Varma S, et al. Role of HRCT in detection and characterization of pulmonary abnormalities in patients with febrile neutropenia. Lung India Off Organ Indian Chest Soc 2013;30(2):124-30.
Nguyen NTB, Le Ngoc H, Nguyen NV, et al. Chronic pulmonary aspergillosis situation among post tuberculosis patients in vietnam: an observational study. J Fungi Basel Switz 2021;7(7):532.
Zhong H, Wang Y, Gu Y, et al. Clinical features, diagnostic test performance, and prognosis in different subtypes of chronic pulmonary aspergillosis. Front Med 2022;9:811807.
Rajpurohit R, Wagh P, Heda M, et al. Prevalence of chronic pulmonary aspergillosis in fibrocavitary pulmonary tuberculosis patients. J Fam Med Prim Care 2023;12(1):106-110.
Lakhtakia L, Spalgais S, Kumar R. Spectrum of pulmonary aspergillus diseases in post TB lung diseases. Indian J Tuberc 2022;69(4):523-9.