A global review study by Denning and colleagues has identified 47 cases of CPA in the paediatric population published from 1963 to 2022: twenty-two were simple aspergillomas, and 11 were chronic cavitary pulmonary aspergillosis. The authors speculate the reported number of cases underestimates the true CPA prevalence in children, likely due to misclassifications as invasive aspergillosis, unclear case definitions, or misdiagnoses with tuberculosis.
Underlying diseases included pulmonary tuberculosis (14.9%), Job’s Syndrome (10.6%), congenital pulmonary airway malformation (8.5%), allergic bronchopulmonary aspergillosis (ABPA) or asthma (6.4%), pulmonary hydatid cyst (4.3%), bacterial pneumonia with cavitation (4.3%), diabetes mellitus (4.3%), and single cases of pulmonary sequestration or bronchogenic cyst. No underlying disease was reported in eighteen (38.3%) cases.
The rarity of the problem means that there are no established cutoff values for Aspergillus IgG antibody testing for CPA in children. In pediatric ABPA, the cutoff values used were those established in adults ( Liu et al, Davies et al, and McDowell et al).
