Allergic Bronchopulmonary Aspergillosis Caused by Aspergillus terreus Presenting Lobar Collapse.

Nakahara, Yoshiaki; Katoh, Osamu; Yamada, Hozumi; Sumida, Ikuo; Hanada, Makoto

doi:10.2169/internalmedicine.31.140

Cited by 12 publications

(5 citation statements)

References 6 publications

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“…Aspergillus terreus is implicated in approximately 10% of ABPA cases in Japan based predominantly on isolation in sputum samples but without serological confirmation. Older reports further support the role of this species complex in the aetiology of selected cases of ABPA [119][120][121]. The species has rarely been related to other forms of fungal disease in non CF-bronchiectasis, suggestive of low pathogenic potential in the non-immunosuppressed host [122].…”

Section: Aspergillus Species In Non-cystic Fibrosis Bronchiectasismentioning

confidence: 93%

Aspergillus Species in Bronchiectasis: Challenges in the Cystic Fibrosis and Non-cystic Fibrosis Airways

Chotirmall

Martín-Gómez

2017

Mycopathologia

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Bronchiectasis is a chronic irreversible airway abnormality associated with infectious agents that either cause or superinfect the airways. While the role of bacteria is well studied, much remains to be determined about fungi in both cystic fibrosis- and non-cystic fibrosis-related bronchiectasis. The airway is constantly exposed to inhaled ambient moulds of which Aspergillus represent the most ubiquitous. In a normal healthy host, this situation is of little consequence. The presence of anatomical or immunological abnormalities such as those in bronchiectasis leads to a range of fungal-related pathologies from asymptomatic airway colonization to fungal sensitization, allergic bronchopulmonary aspergillosis or chronic pulmonary aspergillosis. These entities are difficult to recognize, diagnose and treat due in part to a lack of validated biomarkers. Our true understanding of the complex relationships that regulate fungal-host interactions is still in its infancy and, several questions remain. This includes if fungal epidemiology in bronchiectasis is uniform across countries, and to what extent immunopathological mechanisms-related to fungal airway infections-occurs in different disease states. Specific triggers to allergic or infectious responses to Aspergillus require further exploration. How transition occurs between allergic and invasive phenotypes and their respective biomarkers is also important. Whether anti-fungal treatment is warranted in all cases and what the optimal management strategy is, particularly when treatment should commence and its expected duration remains unclear. Further research is clearly necessary and should be prioritized to better understand the clinical effects and impact of Aspergillus in the setting of bronchiectasis.

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Section: Aspergillus Species In Non-cystic Fibrosis Bronchiectasismentioning

confidence: 93%

Aspergillus Species in Bronchiectasis: Challenges in the Cystic Fibrosis and Non-cystic Fibrosis Airways

Chotirmall

Martín-Gómez

2017

Mycopathologia

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“…The prevalence of ABPA in idiopathic bronchiectasis is 10% [ 62 ]. A. terreus has been implicated in approximately 10% of patients with ABPA in Japan [ 63 , 64 ], but this species is not very pathogenic and is rarely associated with other types of fungal disease in bronchiectasis. A. nidulans has also been described as a cause of ABPA in bronchiectasis patients [ 65 ].…”

Section: Allergic Bronchopulmonary Mycosismentioning

confidence: 99%

Fungi in Bronchiectasis: A Concise Review

Máiz

Nieto

Cantón

et al. 2018

IJMS

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Although the spectrum of fungal pathology has been studied extensively in immunosuppressed patients, little is known about the epidemiology, risk factors, and management of fungal infections in chronic pulmonary diseases like bronchiectasis. In bronchiectasis patients, deteriorated mucociliary clearance—generally due to prior colonization by bacterial pathogens—and thick mucosity propitiate, the persistence of fungal spores in the respiratory tract. The most prevalent fungi in these patients are Candida albicans and Aspergillus fumigatus; these are almost always isolated with bacterial pathogens like Haemophillus influenzae and Pseudomonas aeruginosa, making very difficult to define their clinical significance. Analysis of the mycobiome enables us to detect a greater diversity of microorganisms than with conventional cultures. The results have shown a reduced fungal diversity in most chronic respiratory diseases, and that this finding correlates with poorer lung function. Increased knowledge of both the mycobiome and the complex interactions between the fungal, viral, and bacterial microbiota, including mycobacteria, will further our understanding of the mycobiome’s relationship with the pathogeny of bronchiectasis and the development of innovative therapies to combat it.

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“…Aspergillus fumigatus accounts for the majority of these cases. However, there have been increasing reports of pneumonia and disseminated infections due to Aspergillus terreus [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. These reports underscore the observation that invasive pulmonary aspergillosis caused by A. terreus is often refractory to standard treatment with amphotericin B (AmB).…”

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confidence: 99%

Experimental Pulmonary Aspergillosis Due toAspergillus terreus:Pathogenesis and Treatment of an Emerging Fungal Pathogen Resistant to Amphotericin B

et al. 2003

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Aspergillus terreus is an uncommon but emerging fungal pathogen, which causes lethal infections that are often refractory to amphotericin B (AmB). In comparison to Aspergillus fumigatus, A. terreus was resistant to the in vitro fungicidal effects of safely achievable concentrations of AmB. These in vitro findings correlated directly with resistance of A. terreus to AmB in experimental invasive pulmonary aspergillosis. Residual fungal pulmonary burden and galactomannan antigenemia demonstrated persistent infection, despite therapy with deoxycholate AmB or liposomal AmB. By comparison, posaconazole and itraconazole resolved GM antigenemia, reduced residual fungal burden, and improved survival. There were no differences in phagocytic host response to A. terreus versus A. fumigatus; however, the rate of conidial germination of A. terreus was slower. The strain of A. terreus with the highest minimum inhibitory and minimum lethal concentration of AmB also had the lowest membrane ergosterol content. The hyphae of A. terreus in vivo displayed distinctive aleurioconidia, which may be a practical microscopic feature for rapid preliminary diagnosis.

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Allergic Bronchopulmonary Aspergillosis Caused by Aspergillus terreus Presenting Lobar Collapse.

Abstract: A case of allergic bronchopulmonary aspergillosis (ABPA) is described which presents left upper lobe collapse caused by Aspergillus terreus, an organism rarely found in ABPA. It is unusual for initial radiographic findings of ABPA to include extensive collapse.

Cited by 12 publications

References 6 publications

Aspergillus Species in Bronchiectasis: Challenges in the Cystic Fibrosis and Non-cystic Fibrosis Airways

Aspergillus Species in Bronchiectasis: Challenges in the Cystic Fibrosis and Non-cystic Fibrosis Airways

Fungi in Bronchiectasis: A Concise Review

Experimental Pulmonary Aspergillosis Due toAspergillus terreus:Pathogenesis and Treatment of an Emerging Fungal Pathogen Resistant to Amphotericin B

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