A simple x-ray scoring system for the diagnosis of Chronic Pulmonary Aspergillosis

Mycoses. 2021 Apr 9. doi: 10.1111/myc.13284. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic pulmonary aspergillosis (CPA) is a severe form of post tuberculosis lung disease (PTBLD). Considering the high burden of TB in India, it can be concluded that the prevalence of CPA is also high. Chest x-ray though most feasible, interpretation is subjective. Therefore, decision on evaluation for CPA cannot be based on x-ray alone.

OBJECTIVE: Present study evaluated an x-ray score as a marker for extent of lung damage in patients with PTBLD presenting with hemoptysis and its utility to predict Aspergillus serum IgG levels.

METHODS: We used a modified scoring system developed by Anna Ralph et al. X-ray score cut-offs of >71 and 40, with or without history of massive hemoptysis, were compared with serum IgG levels.

RESULTS: With a chest x-ray score cut-off of 71, specificity was 88%. With an x-ray score of >71 combined with history of massive hemoptysis; 86% cases were found to be IgG positive. The specificity of this combination was 96%.

CONCLUSION: This study concluded that a simple chest x-ray scoring system in addition to the symptom of massive hemoptysis helped in the decision on further evaluation of the subject for CPA, especially in resource constrained settings.

PMID:33835600 | DOI:10.1111/myc.13284