Case Report. Chronic necrotizing pulmonary aspergillosis in a non‐neutropenic patient treated with liposomal amphotericin B

Filippou, N.; Papachristou, K.; Ilias, Ιoannis; Pefanis, Angelos; Papaleftheris, E.; Iliopoulos, Irineos

doi:10.1046/j.1439-0507.2000.00579.x

Cited by 7 publications

(10 citation statements)

References 6 publications

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“…According to the predisposing conditions, most cases of CPA occur in middle‐aged patients, but young CF patients as well as younger adults, e.g. with history of tuberculosis may be affected, too.…”

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

“…[1][2][3][4][5] While neutropenia remains the major risk factor for acute invasive forms of aspergillosis (IA), 6 preexisting pulmonary disease, especially when causing impaired pulmonary clearance predisposes for CPA, 1,5,7 an entity in patients who present with only minor immunosuppression. Underlying pulmonary diseases frequently found in CPA patients are diverse and include history of tuberculosis, 8,9 active atypical mycobacterial infection, [10][11][12][13] chronic obstructive pulmonary disease (COPD), [13][14][15] asthma, cystic fibrosis (CF), ABPA (a condition complicating, e.g. asthma and CF 16 ), prior pneumothorax, treated lung cancer, 7 sarcoidosis, 17 pneumoconiosis, [18][19][20] emphysema, preformed bullae, pneumonia and thoracic surgery.…”

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

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Chronic pulmonary aspergillosis

Schweer,

Bangard,

Hekmat

et al. 2013

Mycoses

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Summary Chronic pulmonary aspergillosis (CPA) is a group of consuming diseases usually presenting with prolonged and relapsing cough, dyspnoea and weight loss. Acute symptoms such as haemoptysis and bronchial or pulmonary haemorrhage may occasionally occur. CPA affects patients with underlying pulmonary conditions, for example, chronic obstructive pulmonary disease or mycobacteriosis or common immunosuppressive conditions such as diabetes. Precise epidemiology is unknown, and while prevalence is considered low the chronic and relapsing nature of the disease challenges the treating physician. Diagnostics largely rely on serologic Aspergillus precipitins and findings on thoracic computed tomography. The latter are manifold comprising cavity formation, pleural involvement and sometimes aspergilloma. Other markers for aspergillosis are less helpful, in part due to the non‐ or semi‐invasive nature of these forms of Aspergillus infection. Various antifungals were shown to be effective in CPA treatment. Azoles are the most frequently applied antifungals in the outpatient setting, but are now compromised by findings of Aspergillus resistance. Long‐term prognosis is not fully elucidated and may be driven by the underlying morbidities. Prospective registry‐type studies may be suitable to systematically broaden our CPA knowledge base. This article gives an overview of the available literature and proposes a clinical working algorithm for CPA management.

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Section: Epidemiology and Pathogenesismentioning

confidence: 99%

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

Chronic pulmonary aspergillosis

Schweer,

Bangard,

Hekmat

et al. 2013

Mycoses

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“…Although pulmonary aspergillosis in non-agranulocytic patients has increased with the development of society, the frequency remains low relative to that in agranulocytic patients. To date, few data are available in nonagranulocytic patients, and most of them are found in case reports [2,[17][18][19]. Consequently, more cases and more studies are urgently needed to understand nonagranulocytic pulmonary aspergillosis to provide more references or clues for the diagnosis and treatment of the disease.…”

Section: Discussionmentioning

confidence: 99%

Potential value of serum Aspergillus IgG antibody detection in the diagnosis of invasive and chronic pulmonary aspergillosis in non-agranulocytic patients

Xing

et al. 2020

BMC Pulm Med

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Background: At present, serum Aspergillus IgG and IgM antibody detection is mainly used in the diagnosis of chronic pulmonary aspergillosis (CPA), but its value in the diagnosis of invasive pulmonary aspergillosis (IPA) in nonagranulocytic patients is still unclear. IgM can be used as a marker of acute infection to help diagnose acute infection-related diseases. IgG is a marker of long-term infection and is used to assist in the diagnosis of preexisting or chronic infection-related diseases. The aim of this study was to investigate and compare the value of serum Aspergillus IgG and IgM antibody detection in the diagnosis of IPA and CPA in non-agranulocytic patients. Methods: Fifty-eight cases of pulmonary aspergillosis (37 IPA and 21 CPA cases), 15 cases of community-acquired bacterial pneumonia and 50 cases in the healthy control group were collected. The serum (1,3)-β-D-glucan test (G test) was performed with a chromogenic method, and the galactomannan test (GM test) and Aspergillus IgG and IgM antibody detection were performed by commercial enzyme-linked immunosorbent assay (ELISA) in all patients. The sensitivity and specificity, cut-off value and area under the curve (AUC) of Aspergillus IgG and IgM antibodies were further obtained by receiver operating characteristic (ROC) curves. Results: The positive rate of the G test, Aspergillus IgG antibody detection and the GM test also showed notable differences among the IPA, CPA, community-acquired bacterial pneumonia and healthy groups (P = 0.006, P < 0.001 and P = 0.217, respectively). Only the positive rate of the GM test showed a significant difference between the IPA and CPA groups (P = 0.04). ROC curves indicated that Aspergillus IgG antibody detection had a higher specificity in the IPA group than in the CPA group (0.952). The detection of Aspergillus IgG antibody can preferably distinguish IPA from community-acquired bacterial pneumonia and healthy controls (sensitivity = 0.923, specificity = 0.459, cutoff value = 134.46, AUC = 0.727). It can also distinguish CPA from community-acquired bacterial pneumonia and healthy controls (sensitivity = 0.952, specificity = 0.692, cut-off value = 75.46, AUC = 0.873). Conclusions: Serum Aspergillus IgG antibody detection may have certain clinical value in the diagnosis of IPA and CPA in non-agranulocytic patients.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of serum Aspergillus IgG antibody for invasive pulmonary aspergillosis and chronic pulmonary aspergillosis in non-agranulocytic patients

Xing

et al. 2020

Preprint

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Background: At present, serum Aspergillus IgG and IgM antibody detection is mainly used in the diagnosis of chronic pulmonary aspergillosis (CPA), but its value in the diagnosis of invasive pulmonary aspergillosis (IPA) in non-agranulocytic patients is still unclear. IgG is a marker of long-term infection and is used to assist in the diagnosis of pre-existing or chronic infection-related diseases. The aim of this study was to investigate and compare the value of serum Aspergillus IgG and IgM antibody detection in the diagnosis of IPA and CPA in non-agranulocytic patients. Methods: Fifty-eight cases of pulmonary aspergillosis (37 IPA and 21 CPA cases), 15 cases of community-acquired bacterial pneumonia and 50 cases in the healthy control group were collected. The serum (1,3)-β-D-glucan test (G test) was performed with a chromogenic method, and the galactomannan test (GM test) and Aspergillus IgG and IgM antibody detection were performed by commercial enzyme-linked immunosorbent assay (ELISA) in all patients. The sensitivity and specificity, cut-off value and area under the curve (AUC) of Aspergillus IgG and IgM antibodies were further obtained by receiver operating characteristic (ROC) curves. Results: The positive rate of the G test, Aspergillus IgG antibody detection and the GM test also showed notable differences among the IPA, CPA, community-acquired bacterial pneumonia and healthy groups ( P = 0.006, P < 0.001 and P = 0.217, respectively). Only the positive rate of the GM test showed a significant difference between the IPA and CPA groups ( P = 0.04). ROC curves indicated that Aspergillus IgG antibody detection had a higher specificity in the IPA group than in the CPA group (0.952). The detection of Aspergillus IgG antibody can preferably distinguish IPA from community-acquired bacterial pneumonia and healthy controls (sensitivity = 0.923, specificity = 0.459, cut-off value = 134.46, AUC = 0.727). It can also distinguish CPA from community-acquired bacterial pneumonia and healthy controls (sensitivity = 0.952, specificity = 0.692, cut-off value = 75.46, AUC = 0.873). Conclusions: Serum Aspergillus IgG antibody detection may have certain clinical value in the diagnosis of IPA and CPA in non-agranulocytic patients.

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Case Report. Chronic necrotizing pulmonary aspergillosis in a non‐neutropenic patient treated with liposomal amphotericin B

Cited by 7 publications

References 6 publications

Chronic pulmonary aspergillosis

Chronic pulmonary aspergillosis

Potential value of serum Aspergillus IgG antibody detection in the diagnosis of invasive and chronic pulmonary aspergillosis in non-agranulocytic patients

Diagnostic value of serum Aspergillus IgG antibody for invasive pulmonary aspergillosis and chronic pulmonary aspergillosis in non-agranulocytic patients

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