Prevalence of chronic pulmonary aspergillosis in patients with tuberculosis from Iran

  • M. T. HedayatiEmail author
  • Y. Azimi
  • A. Droudinia
  • B. Mousavi
  • A. Khalilian
  • N. Hedayati
  • D. W. Denning


In patients with preexisting lung disease, especially a cavity, Aspergillus can infect the surface of the cavity, causing chronic cavitary pulmonary aspergillosis (CCPA), and may form an aspergilloma, collectively called chronic pulmonary aspergillosis (CPA). In the present study, we assessed tuberculosis (TB) patients for CPA based on culture and serological methods. During a period of 1 year (from March 2013 to March 2014), we studied 124 patients with TB (94 with current TB and 30 with previous TB) at Masih Daneshvari Hospital in Tehran, Iran. Sputum specimens were analyzed by direct microscopic examination (DME) and fungal culture. The clinical and radiological features of all patients were recorded, to categorize the patients into CCPA and aspergilloma. All patients were screened for serum-specific IgG against A. fumigatus, by enzyme-linked immunosorbent assay (ELISA). Out of 124 patients with TB (66 male, age range: 10–91 years), 48 patients (38.7 %) exhibited residual cavities. Eighteen (14.5 %) patients had cavities with pleural thickening. A round-shaped mass lesion was detected in six patients (6.8 %). DME was positive in ten patients for septate fungal hyphae. A. fumigatus was grown from 14 samples. Fifty-five (44.3 %) cases were positive for serum-specific IgG against A. fumigatus. Of 124 patients with TB, 3 (2.4 %) met criteria for aspergilloma and 14 (11.3 %) for CCPA. CPA is a common clinical presentation in individuals with healed TB in Iran, as reported by previous studies from other countries.


Aspergillosis Allergic Bronchopulmonary Aspergillosis Residual Cavity Direct Microscopic Examination Chronic Pulmonary Aspergillosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The participating patients are thanked for their kind cooperation, which was essential for the completion of the study. This study was supported by the Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Conflict of interest

The authors declare that there is no conflict of interests. David Denning is President of the Global Action Fund for Fungal Infections (, which aims to improve the outcome of patients with serious fungal infections across the world, including chronic pulmonary aspergillosis after TB.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • M. T. Hedayati
    • 1
    • 2
    Email author
  • Y. Azimi
    • 1
    • 2
  • A. Droudinia
    • 3
  • B. Mousavi
    • 1
    • 2
  • A. Khalilian
    • 4
  • N. Hedayati
    • 5
  • D. W. Denning
    • 6
    • 7
  1. 1.Invasive Fungi Research CenterMazandaran University of Medical SciencesSariIran
  2. 2.Department of Medical Mycology and ParasitologyMazandaran University of Medical SciencesSariIran
  3. 3.Transplantation Research Center, National Research Institute for Tuberculosis and Lung Disease, Masih Daneshvari HospitalShaheed Beheshti University of Medical ScienceTehranIran
  4. 4.Department of Statistics, School of MedicineMazandaran University of Medical ScienceSariIran
  5. 5.Ramsar International BranchMazandaran University of Medical SciencesSariIran
  6. 6.The National Aspergillosis Centre, University Hospital of South ManchesterUniversity of ManchesterManchesterUK
  7. 7.Academic Health Science CentreManchesterUK

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