Epidemiological, clinical, and radiological characteristics of chronic pulmonary aspergillosis in Sri Lanka – A single centre experience

Introduction and objectives: Chronic Pulmonary Aspergillosis (CPA) is a spectrum of chronic progressive lung disease with similar clinical and radiological features as pulmonary tuberculosis (PTB). The aim of this study was to evaluate the epidemiological, clinical, and radiological characteristics of CPA in Sri Lankan patients.

Methods: A cross-sectional descriptive study was carried out on 43 patients with the diagnosis of CPA in the National Hospital of Respiratory Diseases, Welisara, Sri Lanka. Epidemiological, clinical, and radiological data were gathered through an interviewer-administered questionnaire and patient records.

Results: The median age of the population was 61 years and 76.7% were men. Smoking and alcohol consumption were common among them, the odds ratios were not significant for the common types of CPA. The odds ratio was significant (11.73, 95% CI- 1.34- 102.2) for betel and arecanut chewing for the occurrence of the commonest type of CPA. Most of the patients (72.1%) had a personal history of PTB but majority of them (54.9%) did not have a microbiological diagnosis of TB. In the spectrum of CPA, the fibrosing type was the commonest (39.5%) followed by the cavitary type (27.9%). Both lungs were affected in 46.5% of cases, whereas the right lung was commonly involved in unilateral diseases. Itraconazole was the commonest antifungal agent used for treatment.

Conclusions: Fibrosing and cavitary types were the commonest types of CPA in the study population.

Predilection of right lung involvement in unilateral CPA is another finding of this study. Betel and arecanut consumption may be a potential risk factor that needs confirmation through large-scale studies.