DOCSLIB.ORG

Fungal Infections in PIDD Patients

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Fungal Infections in PIDD Patients Funga l Infections in PIDD Patients PIDD patients are more prone to certain types of infections. Knowing which ones they are most susceptible to and how they are most commonly treated can help to minimize the risk. By Alexandra F. Freeman, MD, and Anahita Agharahimi, MSN, CRNP 16 December-January 2014 www.IGLiving.com IG Living! ndividuals with primary immune deficiencies (PID Ds) are (paronychia) or the finger nails and toenails themselves at greater risk for recurrent infections compared with (onychomycosis). Candida can enter the bloodstream and Ithose with normal immune systems. PIDD patients cause more severe infections when the normal skin barriers fre quently have a genetic defect that causes an abnormality are compromised such as with central venous access lines in the number and/or function of one or more compo - (long-term IV access) that are sometimes needed for various nents of the immune system that fights infections. These treatments. These invasive infections usually cause infections can be predominantly viral, bacterial or fungal, fever and more acute illness compared with the more depending on the type of white blood cells affected by the mild infections such as thrush and vaginal yeast infections. specific immune deficiency . For instance, neutrophil Ringworm is also caused by yeasts, including Trichophyton abnormalities lead to recurrent bacterial and mold infections ; and Microsporum species, that cause rashes on the skin or B lymphocytes typically lead to bacterial infections, more scalp. Tinea versicolor is caused by the yeast Malassezia specifically those that antibodies prevent such as furfur and causes a rash usually on the trunk. Streptococcus pneumoniae ( pneumococcus) and Haemophilus influenzae ; and T lymphocytes frequently lead to recurrent viral infections and yeast infections such as Candida. For medical purposes, Other types of immune system abnormalities lead to other specific recurrent infections. fungi are divided into three Individuals with PIDDs often require recurrent courses of antibiotics, which can lead to an imbalance in the normal groups: yeasts, molds and bacteria and fungi (normal flora) that inhabit all of our protective barriers such as the skin, gastrointestinal tract those that can exist as and oral mucosa. This imbalance, in turn, increases vulner - ability to other types of infections such as yeast infections and Clostridium difficile (C. diff) infections. both yeasts and molds What Are Fungi, and What Diseases (dimorphic fungi). Do They Cause? Fungi are categorized as eukaryotes, organisms whose Cryptococcus is a yeast that can be found in the soil, in cells are larger and more complex in their make up wild bird droppings and around certain plants. In healthy com pared with bacteria, which lack nuclei inside the cells, individuals, it rarely causes problems. However, in immune and viruses, which require assistance from host cells (the deficiencies with T lymphocyte abnormalities , it can usually cells it infects) to replicate. For medical purposes, fungi are cause lung infections when it is inhaled. The lung infection divided into three groups: yeasts, molds and those that can look like a mass on chest imaging scans but rarely can exist as both yeasts and molds (dimorphic fungi). causes many symptoms. However, Cryptococcus can Yeasts commonly include Candida species and Cryptococcus spread to the brain and cause meningitis. The meningitis species, with Candida being the more common. Candida symptoms may evolve over weeks to months, which is are a part of human normal flora and mostly reside in the dif ferent from bacterial meningitis, which rapidly causes mouth, gastrointestinal tract and vagina. Problems arise significant illness. This may present with symptoms such as when their numbers multiply in these areas due to the headaches, personality changes or vision changes. eradication of normal bacteria from antibiotic use, Molds are fungi that grow as multicellular organisms med ications like corticosteroids that weaken the immune that usually have branches called hyphae. The most common system, or when the improper function of the immune mold responsible for causing infections is Aspergillus. sys tem allows them to replicate unchecked. Candida can Aspergillus species grow in almost all oxygen-rich environ - cause infections in the mouth, known as thrush, which ments. It is rare for people with normal immune systems appear as white plaques on the inside of the cheeks and to have infection from mold, although breathing in high tongue. It can also cause vaginal yeast infections and quantities of molds can make asthma and other lung diseases dia per rash in infants and young children. And, it can worse. Problems with the neutrophil white blood cells, cause infections on the skin surrounding the fingernails either due to a PIDD (e.g. ,chronic granulomatous disease, December-January 2014 www.IGLiving.com IG Living! 17 Figure 1. plugs. Allergic fungal sinusitis causes thick mucous that often requires sinus surgery to clear. Both ABPA and aller gic fungal sinusitis improve typically with steroids such as prednisone. Dimorphic fungi that are mainly responsible for causing infections include Histoplasmosis, Blastomycosis and Coccidio idomycosis. Histoplasmosis is found in the soil mostly in the Ohio River Valley and lower Mississippi River area and usually causes a self-limited lung infection with a dry cough. Blastomycosis grows in moist or wet environments and vegetation and is found most fre - quently around the Great Lakes. Coccidio ides is found in This chest CT scan of a 23-year-old man with Hyper IgE syndrome shows a cavity in the right lung (thin red arrow) in which there is an aspergilloma the soil of primarily the Southwestern United States and (thick green arrow). Aspergillomas can cause hemoptysis (coughing up blood). causes valley fever, which is a flu-like illness with cough. All three can cause infections in individuals with normal Figure 2. immune systems, but the infections are not usually severe and frequently clear without any medications. Those with PIDDs can develop significant infection affecting the respiratory, neurologic and dermatologic systems from these organisms. What PIDDs Lead to Fungal Infections? As mentioned earlier , individuals with PIDDs have increased risk for certain fungal infections, and the type of PIDD determines the susceptibility to the infection and the severity of illness. CGD is caused by a problem in the neutrophil oxidative burst, which is the chemical end product of neutrophil activity that kills certain bacteria and fungi. This abnor - mal killing ability of neutrophils leads to susceptibility to This individual has a primary immunodeficiency (Hyper IgE syndrome) that leads to recurrent Candida infections. The arrow points to a nail that was infections with molds, most commonly with the infected with Candida. Aspergillus species . These mold infections are usually of the lung, skin or bone and can cause fever and some - times localizing symptoms to the site of infection. or CGD) or to chemotherapy, can cause severe mold Diagnosis is best made by taking a biopsy and sending infec tions that require long-term antifungals and possibly the sample for fungal and bacterial cultures so that surgery to cure. In CGD, pneumonias from molds can spe cific treatment can be given. cause chest pain, cough and fever and may worsen slowly Severe combined immune deficiency (SCID) is caused by over weeks compared with bacterial infections that usually severe abnormalities in T lymphocytes along with B and/or cause more symptoms rapidly. Molds can cause less severe, NK lymphocytes. Affected individuals present early in life but still problematic, chronic pulmonary infections in as infants with recurrent, severe bacterial and viral infec - indi viduals with bronchiectasis (irreversible dilation of tions , as well as failure to grow normally. Lymphocytes are part [s] of the bronchial tubes) or other structural lung also important for the control of yeasts , and infants with problems. People with asthma or cystic fibrosis can develop SCID frequently have yeast infections causing thrush and an allergy to molds and have allergic sinus or lung disease, diaper rash. known as allergic bronchopulmonary aspergillosis (ABPA) Hyper IgE (Job’s) syndrome is caused by mutations in a or allergic fungal sinusitis. ABPA normal ly causes wheezing gene called STAT3, which is needed for T lymphocytes to and productive cough with usually brown-colored mucous mature into a special type of T lymphocyte called a Th17 18 December-January 2014 www.IGLiving.com IG Living! cell. Th17 cells are involved in the control of yeast on the Polyene Antifungals: skin and mucous membranes , and individuals with • Nysta tin is used topically to treat thrush or skin infection s abnormal Th17 cells can have trouble with Candida in with Candida. With thrush, it is usually administered as a the mouth (thrush) , as well as fingernail Candida swish and spit. Side effects are rare. infections and recurrent vaginal yeast infections. Less • Amphotericin has activity against many fungi and is frequently, there can be more severe infections from used frequently for severe infections. Amphotericin use is Cryptococcus, Histoplasmosis, and Coccidio ides. These limited due to its intravenous administration and risk for can cause gas trointestinal infections and, in the case of kidney toxicity. Cryptococcus and Coccidio ides, can cause meningitis. Azole Antifungals: • Miconazole/clotrimazole are topical
Load more

Recommended publications
  • Estimated Burden of Serious Fungal Infections in Ghana
    Journal of Fungi Article Estimated Burden of Serious Fungal Infections in Ghana Bright K. Ocansey 1, George A. Pesewu 2,*, Francis S. Codjoe 2, Samuel Osei-Djarbeng 3, Patrick K. Feglo 4 and David W. Denning 5 1 Laboratory Unit, New Hope Specialist Hospital, Aflao 00233, Ghana; [email protected] 2 Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB-143, Korle-Bu, Accra 00233, Ghana; [email protected] 3 Department of Pharmaceutical Sciences, Faculty of Health Sciences, Kumasi Technical University, P.O. Box 854, Kumasi 00233, Ghana; [email protected] 4 Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; [email protected] 5 National Aspergillosis Centre, Wythenshawe Hospital and the University of Manchester, Manchester M23 9LT, UK; [email protected] * Correspondence: [email protected] or [email protected] or [email protected]; Tel.: +233-277-301-300; Fax: +233-240-190-737 Received: 5 March 2019; Accepted: 14 April 2019; Published: 11 May 2019 Abstract: Fungal infections are increasingly becoming common and yet often neglected in developing countries. Information on the burden of these infections is important for improved patient outcomes. The burden of serious fungal infections in Ghana is unknown. We aimed to estimate this burden. Using local, regional, or global data and estimates of population and at-risk groups, deterministic modelling was employed to estimate national incidence or prevalence. Our study revealed that about 4% of Ghanaians suffer from serious fungal infections yearly, with over 35,000 affected by life-threatening invasive fungal infections.
    [Show full text]
  • Coccidioides Immitis
    24/08/2017 FUNGAL AGENTS CAUSING INFECTION OF THE LUNG Microbiology Lectures of the Respiratory Diseases Prepared by: Rizalinda Sjahril Microbiology Department Faculty of Medicine Hasanuddin University 2016 OVERVIEW OF CLINICAL MYCOLOGY . Among 150.000 fungi species only 100-150 are human pathogens 25 spp most common pathogens . Majority are saprophyticLiving on dead or decayed organic matter . Transmission Person to person (rare) SPORE INHALATION OR ENTERS THE TISSUE FROM TRAUMA Animal to person (rare) – usually in dermatophytosis 1 24/08/2017 OVERVIEW OF CLINICAL MYCOLOGY . Human is usually resistant to infection, unless: Immunoscompromised (HIV, DM) Serious underlying disease Corticosteroid/antimetabolite treatment . Predisposing factors: Long term intravenous cannulation Complex surgical procedures Prolonged/excessive antibacterial therapy OVERVIEW OF CLINICAL MYCOLOGY . Several fungi can cause a variety of infections: clinical manifestation and severity varies. True pathogens -- have the ability to cause infection in otherwise healthy individuals 2 24/08/2017 Opportunistic/deep mycoses which affect the respiratory system are: Cryptococcosis Aspergillosis Zygomycosis True pathogens are: Blastomycosis Seldom severe Treatment not required unless extensive tissue Coccidioidomycosis destruction compromising respiratory status Histoplasmosis Or extrapulmonary fungal dissemination Paracoccidioidomycosis COMMON PATHOGENS OBTAINED FROM SPECIMENS OF PATIENTS WITH RESPIRATORY DISEASE Fungi Common site of Mode of Infectious Clinical
    [Show full text]
  • Redalyc.Morphological Varieties of Trichophyton Rubrum Clinical Isolates
    Revista Mexicana de Micología ISSN: 0187-3180 [email protected] Sociedad Mexicana de Micología México Hernández-Hernández, Francisca; Manzano-Gayosso, Patricia; Córdova-Martínez, Erika; Méndez- Tovar, Luis Javier; López-Martínez, Rubén; García de Acevedo, Beatriz; Orozco-Topete, Rocío; Cerbón, Marco Antonio Morphological varieties of Trichophyton rubrum clinical isolates Revista Mexicana de Micología, núm. 25, diciembre, 2007, pp. 9-14 Sociedad Mexicana de Micología Xalapa, México Available in: http://www.redalyc.org/articulo.oa?id=88302504 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Morphological varieties of Trichophyton rubrum clinical isolates Francisca Hernández-Hernández 1, Patricia Manzano-Gayosso1, Erika Córdova-Martínez1, Luis Javier Méndez-Tovar2, Rubén López-Martínez1, Beatriz García de Acevedo3, Rocío Orozco-Topete3, Marco Antonio Cerbón4 1 Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México. 2Servicio de Dermatología y Micología, Centro Médico Nacional (CMN) Siglo XXI, IMSS. 3Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. 4Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México. México, D. F., México 7 0 Variedades morfológicas de aislamientos clínicos de Trichophyton rubrum 0 2 , 4 1 Resumen. Trichophyton rubrum es el dermatofito antropofílico causante de micosis - 9 superficiales aislado con mayor frecuencia en todo el mundo. Diversas variedades : 5 2 morfológicas de este dermatofito han sido reportadas, lo cual en algunas ocasiones hace A Í difícil su identificación. Nuestro objetivo fue identificar y determinar la frecuencia de G O variedades morfológicas entre los aislados de T.
    [Show full text]
  • Allergic Bronchopulmonary Aspergillosis and Severe Asthma with Fungal Sensitisation
    Allergic Bronchopulmonary Aspergillosis and Severe Asthma with Fungal Sensitisation Dr Rohit Bazaz National Aspergillosis Centre, UK Manchester University NHS Foundation Trust/University of Manchester ~ ABPA -a41'1 Severe asthma wl'th funga I Siens itisat i on Subacute IA Chronic pulmonary aspergillosjs Simp 1Ie a:spe rgmoma As r§i · bronchitis I ram une dysfu net Ion Lun· damage Immu11e hypce ractivitv Figure 1 In t@rarctfo n of Aspergillus Vliith host. ABP A, aHerg tc broncho pu~ mo na my as µe rgi ~fos lis; IA, i nvas we as ?@rgiH os 5. MANCHl·.'>I ER J:-\2 I Kosmidis, Denning . Thorax 2015;70:270–277. doi:10.1136/thoraxjnl-2014-206291 Allergic Fungal Airway Disease Phenotypes I[ Asthma AAFS SAFS ABPA-S AAFS-asthma associated with fu ngaIsensitization SAFS-severe asthma with funga l sensitization ABPA-S-seropositive a llergic bronchopulmonary aspergi ll osis AB PA-CB-all ergic bronchopulmonary aspergi ll osis with central bronchiectasis Agarwal R, CurrAlfergy Asthma Rep 2011;11:403 Woolnough K et a l, Curr Opin Pulm Med 2015;21:39 9 Stanford Lucile Packard ~ Children's. Health Children's. Hospital CJ Scanford l MEDICINE Stanford MANCHl·.'>I ER J:-\2 I Aspergi 11 us Sensitisation • Skin testing/specific lgE • Surface hydroph,obins - RodA • 30% of patients with asthma • 13% p.atients with COPD • 65% patients with CF MANCHl·.'>I ER J:-\2 I Alternar1a• ABPA •· .ABPA is an exagg·erated response ofthe imm1une system1 to AspergUlus • Com1pUcatio n of asthm1a and cystic f ibrosis (rarell·y TH2 driven COPD o r no identif ied p1 rior resp1 iratory d isease) • ABPA as a comp1 Ucation of asth ma affects around 2.5% of adullts.
    [Show full text]
  • Fungal Infection in the Lung
    CHAPTER Fungal Infection in the Lung 52 Udas Chandra Ghosh, Kaushik Hazra INTRODUCTION The following risk factors may predispose to develop Pneumonia is the leading infectious cause of death in fungal infections in the lungs 6 1, 2 developed countries . Though the fungal cause of 1. Acute leukemia or lymphoma during myeloablative pneumonia occupies a minor portion in the immune- chemotherapy competent patients, but it causes a major role in immune- deficient populations. 2. Bone marrow or peripheral blood stem cell transplantation Fungi may colonize body sites without producing disease or they may be a true pathogen, generating a broad variety 3. Solid organ transplantation on immunosuppressive of clinical syndromes. treatment Fungal infections of the lung are less common than 4. Prolonged corticosteroid therapy bacterial and viral infections and very difficult for 5. Acquired immunodeficiency syndrome diagnosis and treatment purposes. Their virulence varies from causing no symptoms to death. Out of more than 1 6. Prolonged neutropenia from various causes lakh species only few fungi cause human infection and 7. Congenital immune deficiency syndromes the most vulnerable organs are skin and lungs3, 4. 8. Postsplenectomy state RISK FACTORS 9. Genetic predisposition Workers or farmers with heavy exposure to bird, bat, or rodent droppings or other animal excreta in endemic EPIDEMIOLOGY OF FUNGAL PNEUMONIA areas are predisposed to any of the endemic fungal The incidences of invasive fungal infections have pneumonias, such as histoplasmosis, in which the increased during recent decades, largely because of the environmental exposure to avian or bat feces encourages increasing size of the population at risk. This population the growth of the organism.
    [Show full text]
  • Therapeutic Class Overview Onychomycosis Agents
    Therapeutic Class Overview Onychomycosis Agents Therapeutic Class • Overview/Summary: This review will focus on the antifungal agents Food and Drug Administration (FDA)-approved for the treatment of onychomycosis.1-9 Onychomycosis is a progressive infection of the nail bed which may extend into the matrix or plate, leading to destruction, deformity, thickening and discoloration. Of note, these agents are only indicated when specific types of fungus have caused the infection, and are listed in Table 1. Additionally, ciclopirox is only FDA-approved for mild to moderate onychomycosis without lunula involvement.1 The mechanisms by which these agents exhibit their antifungal effects are varied. For ciclopirox (Penlac®) the exact mechanism is unknown. It is believed to block fungal transmembrane transport, causing intracellular depletion of essential substrates and/or ions and to interfere with ribonucleic acid (RNA) and deoxyribonucleic acid (DNA).1 The azole antifungals, efinaconazole (Jublia®) and itraconazole tablets (Onmel®) and capsules (Sporanox®) works via inhibition of fungal lanosterol 14-alpha-demethylase, an enzyme necessary for the biosynthesis of ergosterol. By decreasing ergosterol concentrations, the fungal cell membrane permeability is increased, which results in leakage of cellular contents.2,5,6 Griseofulvin microsize (Grifulvin V®) and ultramicrosize (GRIS-PEG®) disrupts the mitotic spindle, arresting metaphase of cell division. Griseofulvin may also produce defective DNA that is unable to replicate. The ultramicrosize tablets are absorbed from the gastrointestinal tract at approximately one and one-half times that of microsize griseofulvin, which allows for a lower dose of griseofulvin to be administered.3,4 Tavaborole (Kerydin®), is an oxaborole antifungal that interferes with protein biosynthesis by inhibiting leucyl-transfer ribonucleic acid (tRNA) synthase (LeuRS), which prevents translation of tRNA by LeuRS.7 The final agent used for the treatment of onychomycosis, terbinafine hydrochloride (Lamisil®), is an allylamine antifungal.
    [Show full text]
  • Pulmonary Aspergillosis: What CT Can Offer Before Radiology Section It Is Too Late!
    DOI: 10.7860/JCDR/2016/17141.7684 Review Article Pulmonary Aspergillosis: What CT can Offer Before Radiology Section it is too Late! AKHILA PRASAD1, KSHITIJ AGARWAL2, DESH DEEPAK3, SWAPNDEEP SINGH ATWAL4 ABSTRACT Aspergillus is a large genus of saprophytic fungi which are present everywhere in the environment. However, in persons with underlying weakened immune response this innocent bystander can cause fatal illness if timely diagnosis and management is not done. Chest infection is the most common infection caused by Aspergillus in human beings. Radiological investigations particularly Computed Tomography (CT) provides the easiest, rapid and decision making information where tissue diagnosis and culture may be difficult and time-consuming. This article explores the crucial role of CT and offers a bird’s eye view of all the radiological patterns encountered in pulmonary aspergillosis viewed in the context of the immune derangement associated with it. Keywords: Air-crescent, Fungal ball, Halo sign, Invasive aspergillosis INTRODUCTION diagnostic pitfalls one encounters and also addresses the crucial The genus Aspergillus comprises of hundreds of fungal species issue as to when to order for the CT. ubiquitously present in nature; predominantly in the soil and The spectrum of disease that results from the Aspergilla becoming decaying vegetation. Nearly, 60 species of Aspergillus are a resident in the lung is known as ‘Pulmonary Aspergillosis’. An medically significant, owing to their ability to cause infections inert colonization of pulmonary cavities like in cases of tuberculosis in human beings affecting multiple organ systems, chiefly the and Sarcoidosis, where cavity formation is quite common, makes lungs, paranasal sinuses, central nervous system, ears and skin.
    [Show full text]
  • PRIOR AUTHORIZATION CRITERIA BRAND NAME (Generic) SPORANOX ORAL CAPSULES (Itraconazole)
    PRIOR AUTHORIZATION CRITERIA BRAND NAME (generic) SPORANOX ORAL CAPSULES (itraconazole) Status: CVS Caremark Criteria Type: Initial Prior Authorization Policy FDA-APPROVED INDICATIONS Sporanox (itraconazole) Capsules are indicated for the treatment of the following fungal infections in immunocompromised and non-immunocompromised patients: 1. Blastomycosis, pulmonary and extrapulmonary 2. Histoplasmosis, including chronic cavitary pulmonary disease and disseminated, non-meningeal histoplasmosis, and 3. Aspergillosis, pulmonary and extrapulmonary, in patients who are intolerant of or who are refractory to amphotericin B therapy. Specimens for fungal cultures and other relevant laboratory studies (wet mount, histopathology, serology) should be obtained before therapy to isolate and identify causative organisms. Therapy may be instituted before the results of the cultures and other laboratory studies are known; however, once these results become available, antiinfective therapy should be adjusted accordingly. Sporanox Capsules are also indicated for the treatment of the following fungal infections in non-immunocompromised patients: 1. Onychomycosis of the toenail, with or without fingernail involvement, due to dermatophytes (tinea unguium), and 2. Onychomycosis of the fingernail due to dermatophytes (tinea unguium). Prior to initiating treatment, appropriate nail specimens for laboratory testing (KOH preparation, fungal culture, or nail biopsy) should be obtained to confirm the diagnosis of onychomycosis. Compendial Uses Coccidioidomycosis2,3
    [Show full text]
  • The Phylogeny of Plant and Animal Pathogens in the Ascomycota
    Physiological and Molecular Plant Pathology (2001) 59, 165±187 doi:10.1006/pmpp.2001.0355, available online at http://www.idealibrary.com on MINI-REVIEW The phylogeny of plant and animal pathogens in the Ascomycota MARY L. BERBEE* Department of Botany, University of British Columbia, 6270 University Blvd, Vancouver, BC V6T 1Z4, Canada (Accepted for publication August 2001) What makes a fungus pathogenic? In this review, phylogenetic inference is used to speculate on the evolution of plant and animal pathogens in the fungal Phylum Ascomycota. A phylogeny is presented using 297 18S ribosomal DNA sequences from GenBank and it is shown that most known plant pathogens are concentrated in four classes in the Ascomycota. Animal pathogens are also concentrated, but in two ascomycete classes that contain few, if any, plant pathogens. Rather than appearing as a constant character of a class, the ability to cause disease in plants and animals was gained and lost repeatedly. The genes that code for some traits involved in pathogenicity or virulence have been cloned and characterized, and so the evolutionary relationships of a few of the genes for enzymes and toxins known to play roles in diseases were explored. In general, these genes are too narrowly distributed and too recent in origin to explain the broad patterns of origin of pathogens. Co-evolution could potentially be part of an explanation for phylogenetic patterns of pathogenesis. Robust phylogenies not only of the fungi, but also of host plants and animals are becoming available, allowing for critical analysis of the nature of co-evolutionary warfare. Host animals, particularly human hosts have had little obvious eect on fungal evolution and most cases of fungal disease in humans appear to represent an evolutionary dead end for the fungus.
    [Show full text]
  • Aspergillomas in the Lung Cavities
    ASPERGILLOMAS IN THE LUNG CAVITIES Eastern Journal of Medicine 3 (1): 7-9, 1998. Aspergillomas in the lung cavities SAKARYA M.E.1, ÖZBAY B.2, YALÇINKAYA İ.3, ARSLAN H.1, UZUN K.2, POYRAZ N.1 Departments of Radiology1and Chest Diseases2,Chest Surgery3 School of Medicine, Yüzüncü Yıl University, Van Objective Pulmonary aspergilloma usually arise from All patients showed cavitary lesions due to healed colonization of aspergillus in preexisting lung cavities. tuberculosis except one. Hemoptisis was the most In this study, we aimed to evaluate computed common complaint. Six patients underwent tomograpy (CT) findings in patients with pulmonary thoracotomy. One patient developed empyema after the aspergilloma. operation. Method We have reviewed 9 patients with aspergilloma, Conclusion CT of the chest in the patients with who referred to the hospital between 1991 and 1996, on aspergilloma is an important diagnostic tool in the their tomographic findings. diagnosis of pulmonary aspergilloma. Results The most common involvement site was upper Key words Pulmonary aspergilloma, computed lobe, which suggested the etiology of tuberculosis. tomography. strongly suggested by a positive precipitin test. CT Introduction clearly demonstrated pulmonary aspergilloma The first description of aspergillosis in man was findings. made by Bennett in 1842. The term aspergilloma was first used by Dave almost a century later to describe a Results discrete lesion that classically colonizes the cavities The most common underlying disease was healed of healed pulmonary tuberculosis and other fibrotic pulmonary tuberculosis. The CT appearance in all lung diseases (1). Pulmonary involvement with was consistent with a diagnosis of aspergilloma. Aspergillus fumigatus is varied and largely dependent In two patients with aspergilloma (22%) the on the patient’s underlying pulmonary and immune lesions were bilateral; in two patients, there were status.
    [Show full text]
  • Allergic Bronchopulmonary Aspergillosis: a Perplexing Clinical Entity Ashok Shah,1* Chandramani Panjabi2
    Review Allergy Asthma Immunol Res. 2016 July;8(4):282-297. http://dx.doi.org/10.4168/aair.2016.8.4.282 pISSN 2092-7355 • eISSN 2092-7363 Allergic Bronchopulmonary Aspergillosis: A Perplexing Clinical Entity Ashok Shah,1* Chandramani Panjabi2 1Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India 2Department of Respiratory Medicine, Mata Chanan Devi Hospital, New Delhi, India This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. In susceptible individuals, inhalation of Aspergillus spores can affect the respiratory tract in many ways. These spores get trapped in the viscid spu- tum of asthmatic subjects which triggers a cascade of inflammatory reactions that can result in Aspergillus-induced asthma, allergic bronchopulmo- nary aspergillosis (ABPA), and allergic Aspergillus sinusitis (AAS). An immunologically mediated disease, ABPA, occurs predominantly in patients with asthma and cystic fibrosis (CF). A set of criteria, which is still evolving, is required for diagnosis. Imaging plays a compelling role in the diagno- sis and monitoring of the disease. Demonstration of central bronchiectasis with normal tapering bronchi is still considered pathognomonic in pa- tients without CF. Elevated serum IgE levels and Aspergillus-specific IgE and/or IgG are also vital for the diagnosis. Mucoid impaction occurring in the paranasal sinuses results in AAS, which also requires a set of diagnostic criteria. Demonstration of fungal elements in sinus material is the hall- mark of AAS.
    [Show full text]
  • 25 Chrysosporium
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Universidade do Minho: RepositoriUM 25 Chrysosporium Dongyou Liu and R.R.M. Paterson contents 25.1 Introduction ..................................................................................................................................................................... 197 25.1.1 Classification and Morphology ............................................................................................................................ 197 25.1.2 Clinical Features .................................................................................................................................................. 198 25.1.3 Diagnosis ............................................................................................................................................................. 199 25.2 Methods ........................................................................................................................................................................... 199 25.2.1 Sample Preparation .............................................................................................................................................. 199 25.2.2 Detection Procedures ........................................................................................................................................... 199 25.3 Conclusion .......................................................................................................................................................................200
    [Show full text]