Chronic Pulmonary Aspergillosis Service For Adults

What is chronic pulmonary aspergillosis?

Chronic pulmonary aspergillosis (CPA) refers to a group of conditions which involve a long-term lung infection of an Aspergillus fungus. It is commonly associated with individuals with normal functioning immune systems but who have underlying lung diseases such as sarcoidosis, tuberculosis, chronic obstructive pulmonary disease (COPD) etc. Individuals with CPA may present with coughing up blood (haemoptysis) along with other non-specific symptoms such as weight loss, cough and fatigue present for at least 3 months.

To determine the type of CPA a person may have one of the following:

  • An image of their lungs (either using a chest x-ray or a CT scan) which may show single or multiple lung cavities, which are abnormal spaces in the lungs.
  • Blood tests will be positive for raised levels of antibodies against Aspergillus which shows that the body is currently trying to fight off an Aspergillus infection.
  • A lung sample taken grows Aspergillus or shows evidence of its infection under a microscope.

All of these have been present for at least 3 months.

What services are offered by the Manchester Rare Conditions Centre?

Due to the non-specific symptoms of CPA, it can be difficult to diagnose and manage. The Manchester Rare Conditions Centre offers a multidisciplinary team of experts specialising in the diagnosis and management of Aspergillus fungal infections. They aim to reduce symptoms and stop the disease from getting worse. Treatment plans are tailored to the specific type of CPA the patient has, and may include:

  • Taking lifelong anti-fungal medication.
  • Optimisation of the management of any underlying lung disease.
  • Having surgery to remove single aspergillomas, which is a mass caused by the Aspergillus infection that can develop within lung cavities.

Patients will be required to have regular chest X-rays to monitor the progress of their CPA as well as blood tests to monitor the levels of antifungals to ensure they’re on the correct dose. In less than 10% of cases the infection can go away on its own, but for most people with CPA treatment is lifelong.

 

Credits:

Ines Djedje – University of Mancheser 5th year medical student

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