Aspergillus infection in chronic obstructive pulmonary diseases

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic airway non‐specific inflammatory disease characterised by airway obstruction and alveolar destruction. In recent years, due to the extensive use of antibiotics, glucocorticoids, immunosuppressants and other drugs, pulmonary fungal infection in patients with AECOPD, especially aspergillus infection, has gradually increased. The forms of aspergillus infection present in COPD patients include sensitisation, chronic pulmonary aspergillosis (CPA) and invasive pulmonary aspergillosis (IPA). This review will summarise diagnostic and treatment of aspergillus in COPD patients.

Pulmonary Aspergillosis in People with Cystic Fibrosis

“…It is almost always caused by A. fumigatus. 106,107 Fortunately, CPA and aspergilloma are very rare in CF and is described only in single cases from the early 1990s but will be described here as a differential diagnosis in CF. 108,109 Treatment of pulmonary aspergilloma in CF by percutaneous instillation of amphotericin B via indwelling catheter was described, 110 as well as successful treatment with voriconazole.…”

“…Experts from ESCMID and ERS developed clinical, radiological, and microbiological recommendations. 106,107 The diagnosis of rarely occurring CPA in pwCF requires, as usual, observation of the following characteristics:…”

“…Different forms of CPA according to the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and European Respiratory Society (ERS) are as follows 106 107 : (1) chronic cavitary pulmonary aspergillosis (CCPA), (2) subacute invasive aspergillosis (SAIA), (3) chronic fibrosing pulmonary aspergillosis (CFPA), (4) Aspergillus nodules, and (5) single/simple aspergilloma. The most common form of CPA is CCPA, which, untreated, may progress to CFPA.…”

“…SAIA, formerly known as chronic necrotizing pulmonary aspergillosis, is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. 106 107 Few clinical guidelines have been previously proposed for diagnosing or managing CPA. Experts from ESCMID and ERS developed clinical, radiological, and microbiological recommendations.…”

“…Experts from ESCMID and ERS developed clinical, radiological, and microbiological recommendations. 106 107…”