Aspergillus‐Related Lung Disease

Al-Alawi, Alia; Ryan, C. Frank; Flint, Julia; Müller, Néstor L.

doi:10.1155/2005/759070

Cited by 45 publications

(39 citation statements)

References 146 publications

(139 reference statements)

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“…However, steroid therapy inhibits the killing of conidia and hyphae by macrophages and the migration of neutrophils around the fungus (1,20,21). Three CPA patients in this study were treated for long periods (over two years) with prednisolone, although the dose was low, under 7.5 mg daily.…”

Section: Discussionmentioning

confidence: 99%

“…Echinocandins, such as micafungin, can be considered as alternative or salvage therapy (3). Successful treatment of IPA depends on the ability to obtain an early diagnosis and provide prompt treatment, as any delay is associated with a high mortality rate (20). Therefore, treatment should be initiated empirically without waiting for a definitive diagnosis in patients suspected of having IPA.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Features of Pulmonary Aspergillosis Associated with Interstitial Pneumonia

et al. 2014

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Objective We retrospectively investigated the clinical features of pulmonary aspergillosis associated with interstitial pneumonia. Methods We reviewed the medical records of all patients treated for interstitial pneumonia with or without pulmonary aspergillosis at our institution between April 2006 and August 2012 and evaluated the clinical features as well as risk and prognostic factors for pulmonary aspergillosis associated with interstitial pneumonia. Results Among 539 patients with interstitial pneumonia, 15 who suffered from pulmonary aspergillosis were identified. The median age was 69.2±7.0 years, and fourteen patients were men. The subtypes of pulmonary aspergillosis were chronic pulmonary aspergillosis (n=14) and invasive pulmonary aspergillosis (n= 1). The forms of interstitial pneumonia included idiopathic pulmonary fibrosis (n=9), rheumatoid arthritisrelated interstitial pneumonia (n=4) and pleuroparenchymal fibroelastosis (n=2). The underlying conditions were emphysema (n=9) and a history of oral corticosteroid and/or immunosuppressive use (n=4). Home oxygen therapy (HOT) was administered in 11 patients. Following the diagnosis of pulmonary aspergillosis, all patients were treated with antifungal drugs. Ten patients (66.6%) died. A comparison of the interstitial pneumonia patients with and without pulmonary aspergillosis showed that the presence of emphysema, use of HOT and death were significantly associated with pulmonary aspergillosis. Conclusion Pulmonary aspergillosis is one of the major complications of interstitial pneumonia and its prognosis is poor. Therefore, providing careful monitoring and proper treatment is extremely important.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Features of Pulmonary Aspergillosis Associated with Interstitial Pneumonia

et al. 2014

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“…Bacteria and viruses have been implicated as the major cause of COPD exacerbations, whereas the potential role of fungal colonisation and infection in the pathogenesis of COPD is poorly understood. The commonest fungal genus to cause pulmonary-associated fungal infections is Aspergillus [7], with a wide spectrum of syndromes, including saprophytic invasion, allergic disease and invasive aspergillosis [8], often due to Aspergillus fumigatus [7]. Additionally, allergic bronchopulmonary aspergillosis (ABPA) [9][10][11][12], found commonly in asthma and cystic fibrosis [13], is increasingly recognised in COPD [14].…”

Section: Introductionmentioning

confidence: 99%

Aspergillus fumigatusduring stable state and exacerbations of COPD

Bafadhel

McKenna²,

Agbetile³

et al. 2013

Eur Respir J

132

127

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Bacteria are often isolated in stable chronic obstructive pulmonary disease (COPD). Whether fungi are also commonly present and associated with clinical and pathological features of disease is uncertain. We investigated the frequency of filamentous fungal culture and IgE sensitisation to Aspergillus fumigatus and the relationship to clinical outcomes in COPD subjects.COPD subjects were recruited to enter a 1-year observational study. Assessments of lung function, allergen testing and sputum analysis for inflammation, bacteria and fungus were undertaken in COPD subjects and healthy smoking and nonsmoking controls.Filamentous fungi were cultured at baseline in 49% (63 out of 128) of COPD subjects, of which 75% (47 out of 63) were A. fumigatus. Fungus was cultured in three out of 22 controls (two were A. fumigatus). The total sputum cell count and inhaled corticosteroid dosage were significantly increased in COPD patients with a positive filamentous fungal culture at baseline (p,0.05). Sensitisation to A. fumigatus was present in 13% of COPD subjects and was associated with worse lung function (forced expiratory volume in 1 s 39% predicted versus 51% predicted; p50.01), but not related to filamentous fungal culture.A. fumigatus sensitisation is related to poor lung function. Positive filamentous fungal culture is a common feature of COPD. The clinical significance of this remains uncertain. @ERSpublications A. fumigatus sensitisation links to poor COPD lung function; clinical significance of positive fungal culture is unclear

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“…Invasive aspergillosis is a major cause of morbidity and mortality in immunosuppressed patients. 2 The form that Aspergillus lung disease takes is heavily dependent on the immune response of the patient. 3 Indolent forms of locally invasive aspergillosis in the form of chronic necrotising or semi-invasive aspergillosis in apparently immunocompetent individuals are now recognised.…”

Section: Discussionmentioning

confidence: 99%