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Emerg Infect Dis. 2018 Aug;24(8). doi: 10.3201/eid2408.171312.

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

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.

KEYWORDS:

Aspergillus; Tuberculosis; antibody; aspergilloma; developing countries; fungi; imaging; resource-constrained settings; tuberculosis and other mycobacteria

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