Invasive Aspergillosis and Chronic Obstructive Pulmonary Disease

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The incidence of invasive pulmonary aspergillosis (IPA) has increased in recent years because of the simultaneous increase of immunosuppressed patients. Reports of cases of patients with chronic obstructive pulmonary disease (COPD) with IPA have also increased. In the immunosuppressed population, a high index of clinical suspicion improves early diagnosis, allowing success rates of 30% to 50%. However, in patients with COPD, the mortality rate is close to 100%. Delay in treatment is related to a low index of clinical suspicion and could be the main factor leading to mortality. Moreover, the finding of other pathogenic microorganisms in respiratory samples could be another factor that delays treatment. It is important to bear in mind that patients with COPD are at a high risk of developing IPA, and persistence of pulmonary infiltrates or clinical deterioration should alert physicians to the possibility of IPA. In general, we agree with other authors that the guidelines set forth by the Centers for Disease Control should include patients with COPD in the list of high-risk patients.

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