{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T21:29:53Z","timestamp":1792877393766,"version":"4.5.0"},"reference-count":33,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2016,11,10]]},"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Pulmonary aspergillosis has variable course of illness, severity and outcomes depending on underlying conditions. There is limited data available on the clinical manifestations and outcome of pulmonary aspergillosis from Pakistan.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>To determine the clinical manifestations and outcome of pulmonary aspergillosis in a tertiary care hospital a retrospective study was conducted from 2004 to 2014 in patients admitted with pulmonary aspergillosis at the Aga Khan University Hospital Karachi, Pakistan.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 280 cases with provisional diagnosis of aspergillosis 69 met the inclusion criteria. The mean age was 45\u00b115.7\u2005years, 48 (69.6%) were men and 21 (30.4%) had diabetes mellitus (DM). The average length of hospital stay (LOS) was 10.61\u00b19.08\u2005days. <jats:italic>Aspergillus fumigatus<\/jats:italic> was the most common (42.0%), followed by <jats:italic>Aspergillus flavus<\/jats:italic> (28.9%). More than one-third of patients previously had tuberculosis (TB) (39.13%). The commonest pulmonary manifestation was chronic pulmonary aspergillosis (CPA) 47 (68.1%) followed by invasive pulmonary aspergillosis (IPA) 12 (17.4%) and subacute invasive aspergillosis (SAIA) 8 (11.6%). Surgical excision was performed in 28 patients (40.57%). Intensive care unit admission was required for 18 patients (26.08%). Case fatality rate was 14\/69 (20.3%). DM, mean LOS and hypoxic respiratory failure were identified as independent risk factors of mortality on multivariate analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>\n                     <jats:italic>A. fumigatus<\/jats:italic> was the most frequent species found especially in patients with prior TB. CPA was the commonest pulmonary manifestation seen as post TB sequel. Diabetes, hypoxic respiratory failure and increased LOS were independent predictors of poor outcomes. Overall patients had good outcome with CPA compared with SAIA and IPA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2016-000155","type":"journal-article","created":{"date-parts":[[2016,12,24]],"date-time":"2016-12-24T13:36:25Z","timestamp":1482586585000},"page":"e000155","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Clinical manifestations and outcomes of pulmonary aspergillosis: experience from Pakistan"],"prefix":"10.1136","volume":"3","author":[{"given":"Nousheen","family":"Iqbal","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Irfan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Bin Sarwar","family":"Zubairi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kauser","family":"Jabeen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safia","family":"Awan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javaid A","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,12,16]]},"reference":[{"key":"2025083111140970000_3.1.e000155.1","doi-asserted-by":"publisher","DOI":"10.1086\/525258"},{"key":"2025083111140970000_3.1.e000155.2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200007000-00006"},{"key":"2025083111140970000_3.1.e000155.3","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00001011"},{"key":"2025083111140970000_3.1.e000155.4","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.11.089441"},{"key":"2025083111140970000_3.1.e000155.5","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00583-2015"},{"key":"2025083111140970000_3.1.e000155.6","doi-asserted-by":"publisher","DOI":"10.1086\/588660"},{"key":"2025083111140970000_3.1.e000155.7","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-86-4-405"},{"key":"2025083111140970000_3.1.e000155.8","doi-asserted-by":"crossref","unstructured":"Campbell CK , Johnson EM , Warnock DW . Identification of yeasts, in identification of pathogenic fungi. 2nd edn. Oxford, UK: Wiley-Blackwell, 2013.","DOI":"10.1002\/9781118520055"},{"key":"2025083111140970000_3.1.e000155.9","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2008-740ST"},{"key":"2025083111140970000_3.1.e000155.10","first-page":"92","article-title":"Prevalence and fungal profile of pulmonary aspergillosis in immunocompromised and immunocompetent patients of a tertiary care hospital","volume":"3","author":"Ved","year":"2014","journal-title":"Int J Med Res Health Sci"},{"key":"2025083111140970000_3.1.e000155.11","doi-asserted-by":"publisher","DOI":"10.1086\/422009"},{"key":"2025083111140970000_3.1.e000155.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0954-6111(05)80051-4"},{"key":"2025083111140970000_3.1.e000155.13","first-page":"190","article-title":"Clinical profile and postoperative outcome in patients with simple and complex aspergilloma of lung","volume":"20","author":"Ahmad","year":"2010","journal-title":"J Coll Physicians Surg Pak"},{"key":"2025083111140970000_3.1.e000155.14","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00054810"},{"key":"2025083111140970000_3.1.e000155.15","first-page":"206","article-title":"Aspergilloma with active pulmonary tuberculosis","volume":"34","author":"Boghani","year":"1987","journal-title":"Indian J Tuberc"},{"key":"2025083111140970000_3.1.e000155.16","first-page":"55","article-title":"Co-existence of HIV, active tuberculosis and aspergilloma in a single individual\u2014a case report","volume":"60","author":"Singh","year":"2013","journal-title":"Indian J Tuberc"},{"key":"2025083111140970000_3.1.e000155.17","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70282-8"},{"key":"2025083111140970000_3.1.e000155.18","first-page":"144","article-title":"Type 2 diabetes mellitus as a risk factor for tuberculosis","volume":"4","author":"Garc\u00eda-Elorriaga","year":"2014","journal-title":"J Mycobac Dis"},{"key":"2025083111140970000_3.1.e000155.19","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-201756"},{"key":"2025083111140970000_3.1.e000155.20","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-81"},{"key":"2025083111140970000_3.1.e000155.21","first-page":"685","article-title":"Successfully treated invasive pulmonary aspergillosis in a patient with diabetic ketoacidosis. Case report","volume":"8","author":"Kumagai","year":"2013","journal-title":"Cent Eur J Med"},{"key":"2025083111140970000_3.1.e000155.22","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/S0954-6111(98)90201-3","article-title":"Invasive pulmonary aspergillosis in an insulin-dependent diabetic","volume":"92","author":"Janes","year":"1998","journal-title":"Respir Med"},{"key":"2025083111140970000_3.1.e000155.23","doi-asserted-by":"publisher","DOI":"10.1186\/cc4823"},{"issue":"2","key":"2025083111140970000_3.1.e000155.24","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1469-0691.2001.tb00006.x","article-title":"Chronic forms of pulmonary aspergillosis","volume":"7","author":"Denning","year":"2001","journal-title":"Clin Microbiol Infect"},{"key":"2025083111140970000_3.1.e000155.25","doi-asserted-by":"publisher","DOI":"10.1080\/13693780500064771"},{"key":"2025083111140970000_3.1.e000155.26","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1200\/JCO.1999.17.3.796","article-title":"Pneumonia in febrile neutropenic patients and in bone marrow and blood stem-cell transplant recipients: use of high-resolution computed tomography","volume":"17","author":"Heussel","year":"1999","journal-title":"J Clin Oncol"},{"key":"2025083111140970000_3.1.e000155.27","doi-asserted-by":"publisher","DOI":"10.1097\/00005382-199904000-00008"},{"key":"2025083111140970000_3.1.e000155.28","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198203000-00005"},{"key":"2025083111140970000_3.1.e000155.29","doi-asserted-by":"publisher","DOI":"10.1086\/518852"},{"key":"2025083111140970000_3.1.e000155.30","doi-asserted-by":"publisher","DOI":"10.1186\/cc3488"},{"key":"2025083111140970000_3.1.e000155.31","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2002.01012.x"},{"key":"2025083111140970000_3.1.e000155.32","doi-asserted-by":"crossref","first-page":"375","DOI":"10.4161\/viru.28291","article-title":"Are respiratory complications more likely in patients with pulmonary aspergillosis treated with echinocandins in the setting of neutrophil influx?","volume":"5","author":"Kontoyiannis","year":"2014","journal-title":"Virulence"},{"key":"2025083111140970000_3.1.e000155.33","doi-asserted-by":"crossref","first-page":"pii: bcr2014206047","DOI":"10.1136\/bcr-2014-206047","article-title":"Empyema necessitatis due to Aspergillus fumigatus","volume":"2014","author":"Lee","year":"2014","journal-title":"BMJ Case Rep"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2016-000155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T18:14:18Z","timestamp":1756664058000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2016-000155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,12,16]]},"published-print":{"date-parts":[[2016,12]]}},"alternative-id":["10.1136\/bmjresp-2016-000155"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2016-000155","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12]]}}}