The occurrence of invasive pulmonary Aspergillosis in chronic obstructive pulmonary disease between March 2015 and March 2017

Background: In chronic obstructive pulmonary disease (COPD) subjects, defect of ciliary activity, immunosuppression effects of alveolar macrophage and neutrophil by using steroids and broad-spectrum antibiotics, play a main role in the development of Invasive Pulmonary Aspergillosis (IPA). Our objective is to evaluate the occurrence of invasive pulmonary Aspergillosis in chronic obstructive pulmonary disease. Patients and Methods: All patients ( 68) with a positive culture of Aspergillus from lower respiratory tract samples referred to lung clinic of Velayat hospital, were examined . For this cross sectional, study data were evaluated from 10 COPD patients in GOLD stage 3 or 4 with isolation of Aspergillus from bronchoscopy biopsy. The data from these participants were obtained by a check list based on patient’s electronics records (history and pathology findings). The descriptive analysis methods were applied. Results: Age range was 63 ± 4 years and 8 patients were male. Smoking history was present in all patients. Main chief complaint was dyspnea (100%) followed by cough (90%) and sputum production and fever came next in order. The most frequent abnormality in chest x ray was infiltration 70%. Cavitation and consolidation came next in order. The hyphae a structure consists with Aspergillus were found in pathological examination of transbronchial biopsy specimens in all patient. Conclusions: In severe and very severe COPD patients with clinical presentation of dyspnea exacerbation, poor clinical conditions, and new pulmonary consolidations on chest X ray under therapy with broad-spectrum antibiotics and steroids, IPA should be taken as main differential diagnosis.