Source: International Congress 2014 – Different interesting issues in respiratory infections: 1
Disease area: Respiratory infections

Abstract

Introduction: Nontuberculous mycobacteria (NTM) and Aspergillus are ubiquitous in nature. Lung disease associated to coexistence of both has been increasingly reported in the literature.Objective: Characterize the incidence of related lung disease to Aspergillus in patients (pts) with NTM isolated in pulmonary specimens.Methods: Retrospective analysis of pts followed in Pulmonology department (Jan/08 to Dec/12) with the isolation of NTM in at least one respiratory specimen, and evaluation of the microbiological and serological Aspergillus profile.Results: 202 pts had NTM isolated from respiratory specimens and treatment was realized in 18% (89% with ATS/IDSA criteria). Pulmonary comorbidities: COPD in 36% pts, bronchiectasis 31% and sequelae of tuberculosis 20%. Aspergillus was isolated in 12% (25) pts (54 isolates): 39 A.fumigatus (AF), 11 A.niger, 3 A.Flavus and 1 A.terreus. Immunology AF (available in about 1/3 pts): median IgG 26.10 (2.06 to 200), IgE positive in 6% (13) pts (0.14 to 10.70), precipitins positive in 5% (10) pts and median total IgE 42 (<0.10 to 3342). ABPA was diagnosed in 2% (4) pts and chronic necrotizing aspergillosis in another 2% (4) pts, and all received treatment (except one). Half of these pts treated for Aspergillus lung disease didn't have Aspergillus isolation. Only 1% (2) of pts received treatment (sequential) for both NTM and Aspergillus lung disease.Conclusion: There was significant isolation of Aspergillus, particularly AF, but Aspergillus related lung disease was rare. The coexistence of Aspergillus and NTM related lung disease may exist, and clinicians should be aware.

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Citations should be made in the following way:
H. Dabó, V. Santos, A. Amorim, A. Ramos, T. Carvalho, M. Ribeiro, A. Marinho (Porto, Portugal). Nontuberculous mycobacteria and aspergillus coexistence in pulmonary disease – Retrospective analysis. Eur Respir J 2014; 44: Suppl. 58, 2553

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