{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T19:21:32Z","timestamp":1768504892552,"version":"3.49.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"S\u00e3o Paulo Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Antimicrobial Resistance Institute of S\u00e3o Paulo-ARIES","award":["FAPESP 2021\/10599-3"],"award-info":[{"award-number":["FAPESP 2021\/10599-3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Data on clinical characteristics and prognosis of chronic pulmonary aspergillosis (CPA) in resource-limited, high tuberculosis (TB) burden settings, especially in Brazil, remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study evaluated all CPA cases diagnosed between 2012 and 2018 across eight centers in Brazil, examining clinical presentation, diagnosis, treatment, mortality, and factors associated with death, including differences related to pulmonary TB. To identify independent predictors of mortality, we conducted multivariate Cox regression. One-year mortality was analyzed using Kaplan\u2013Meier survival curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 191 CPA cases were diagnosed, with a median age of 50 years (IQR 40\u201359) and 62% were male. TB was the most frequent predisposing condition (n = 138, 72%). Most patients (80%) received antifungal therapy, primarily itraconazole (n = 140, 73%). Surgery was performed in 34% of cases. According to Kaplan\u2013Meier analysis, the cumulative mortality at 12 months was 6%. Compared to survivors, nonsurvivors had significantly lower rates of TB (52% vs 77%, P = .019) and higher rates of malignancies (13% vs 3%, P = .033). In multivariate analysis, only TB was independently associated with lower mortality (HR 0.413, 95% CI: .179\u2013.954, P = .038). The TB group showed more hemoptysis (P = .008) and greater radiological involvement, suggesting delayed diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Brazil, the mortality of CPA was lower compared with that reported in previous studies, particularly among patients with TB. In TB-endemic, resource-limited settings, overlapping clinical and radiological features may delay diagnosis and antifungal treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf746","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T12:38:33Z","timestamp":1768048713000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Features and Mortality of Chronic Pulmonary Aspergillosis in Brazil: a Multicenter Cohort Study"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2097-389X","authenticated-orcid":false,"given":"V\u00edtor Falc\u00e3o","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Hospital das Cl\u00ednicas da Faculdade de Medicina, University of S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]},{"name":"Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo , S\u00e3o Paulo 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Universidade Federal de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]},{"name":"Hospital Israelita Albert Einstein , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme","family":"Santoro-Lopes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Silva Rodrigues","sequence":"additional","affiliation":[{"name":"Instituto Clemente Ferreira, Secretaria de Estado da Saude , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9rio Rodrigues","family":"Aquino","sequence":"additional","affiliation":[{"name":"Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7996-8265","authenticated-orcid":false,"given":"Marcello Mihailenko Chaves","family":"Magri","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Hospital das Cl\u00ednicas da Faculdade de Medicina, University of S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2251","authenticated-orcid":false,"given":"David W","family":"Denning","sequence":"additional","affiliation":[{"name":"Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre , Manchester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnaldo L","family":"Colombo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious 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