Pulmonary Aspergillosis in an Unselected Hospital Population

Twenty patients with chest illness due to the fungi Aspergillus fumigatus or Aspergillus niger were seen consecutively over a period of five years in routine hospital practice. Of these, six had mycetomas, of whom four died; 12 had bronchopulmonary aspergillosis, while in only two was there evidence of tissue invasion, in both cases as a complication of severe coccal pneumonia. One additional patient had what was evidently a purely saprophytic infestation of his bronchial tree, with no evidence of hypersensitivity or immune disturbance. A series of 21 men with chronic bronchitis from the same hospital practice showed no evidence of aspergillosis, nor were Aspergillus species isolated from the sputum as commensals. The pathogenesis, management and outcome of the three groups of cases are described.