Friday, 16 December 2011

Patients Die as Aspergillosis is Misdiagnosed as Tuberculosis

Progressive appearance of lung cavities caused by Tb
Tuberculosis (Tb) has a long and terrible history as mankind has fought it for hundreds if not thousands of years. Before the advent of antibiotics it killed millions of people and animals when it was commonly referred to as 'consumption'. 200 years ago it accounted for one in four of all deaths in England, but by the 1980's that had fallen to 5000  deaths per year. More recently that number has started to slowly  rise as the infectious bacteria (Mycobacterium tuberculosis) started to acquire resistance to the antibiotics used against it.

Despite all these advances Tuberculosis today infects or has infected one third of the population of the world (though not all go on to develop Tb) and new infections occur roughly one every second!

Precisely because Tb is such a common infection doctors have to cope with huge numbers of patients, particularly in the developing world. There is a well established routine once doctors see a typical chest X-ray - give antibiotics and continue to monitor and little more is done about it - but unfortunately there is a hidden killer lurking that effects over 1 million people throughout the world.

Macrophage eating Tuberculosis bacteria
Chronic Pulmonary Aspergillosis (CPA) is a fungal disease that can grow in damaged parts of our lungs, evading our immune systems using scar tissue as a 'shield' to avoid detection. It looks very like, or is identical to Tb when doctors look at it on a chest X-ray and has very similar symptoms initially. Doctors mistake it for Tb and prescribe antibiotics as is standard practice.
Unfortunately fungi (e.g. Aspergillus fumigatus) that are as at home in the warm recesses of our lungs as they are in their more natural habitat of compost heaps are not effected by antibiotics and overmore are helped if the patient has poor body weight, diabetes, smokes or has AIDS. If not given correct treatment (antifungal medication) the prognosis is that 50% of those infected will die inside 5 years.

This recent article attempts to highlight this deadly problem and to ask for doctors to look a little more closely at their cases of Tb and how they progress and to consider Chronic Pulmonary Aspergillosis as a real alternative diagnosis. more...

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