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Chronic pulmonary aspergillosis - case series and review of Indian literature

Aspergillus species, especially Aspergillus fumigatus, can cause varied pulmonary manifestations depending on the host immune status and duration of infection. Chronic pulmonary aspergillosis (CPA) is an under-reported entity, and its diagnosis remains a diagnostic challenge for clinicians. CPA can have varied presentations including chronic cavitary pulmonary aspergillosis (CCPA), subacute invasive pulmonary aspergillosis, and chronic fibrosing pulmonary aspergillosis. Underlying lung diseases such as chronic obstructive pulmonary disease and sequelae of pulmonary tuberculosis predisposes these individuals to CPA. These cases can present as chronic cough with hemoptysis even requiring emergency bronchial artery embolization. Here, we present a series of four CCPA cases who were diagnosed on the basis of clinico-radiological features and the Aspergillus-specific IgG antibody levels. A review of case series published in India is also presented.