CT Imaging Assessment of Response to Treatment in Chronic Pulmonary Aspergillosis

Ingrand, Pierre; Carette, M.F.; Frat, Jean‐Pierre; Roblot, F.; Laurent, François; Camara, B.; Pison, C.; Beigelman-Aubry, Cathérine; Cottin, Vincent; Germaud, P.; Khalil, Antoine; Toper, C.; Béraud, Guillaume; Blouin, P.; Philippe, B.; Godet, C.; Cadranel, Jacques; Bergeron, Anne

doi:10.1016/j.chest.2016.02.640

Cited by 66 publications

(64 citation statements)

References 18 publications

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“…Lifelong therapy is required in a subset of patients with progressive disease (Patterson et al, 2016). Radiographic variation in cavity/ pleural thickening and reduction/resolution of fungal ball can be used for assessment of the treatment response (Godet et al, 2016).…”

Section: Chronic Pulmonary Aspergillosis: Clinical Picture and Managementioning

confidence: 99%

Post tuberculosis treatment infectious complications

Hsu

Irfan

Jabeen

et al. 2020

International Journal of Infectious Diseases

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Following greater attention and follow-up of patients with treated pulmonary tuberculosis (TB), it has emerged that infections are more likely to occur in this cohort of patients. This comes as no surprise, as pulmonary TB is a destructive process that leads to cicatrization, alteration of parenchyma, bronchiectasis, and scarring of the lung, with reduction of lung volumes and an impact on pulmonary function. In addition to relapse and re-infection with TB, other pathogens are increasingly recognized in post-TB patients. This paper serves as a summary and guide on how to approach the post-TB patient with new signs and symptoms of pulmonary infection in order to ensure optimal management and rehabilitation.

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Section: Chronic Pulmonary Aspergillosis: Clinical Picture and Managementioning

confidence: 99%

Post tuberculosis treatment infectious complications

Hsu

Irfan

Jabeen

et al. 2020

International Journal of Infectious Diseases

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“…It is reported that clinical long-term azole therapy tends to promote the emergence of the azoleresistant strains (Camps et al, 2012;Tashiro et al, 2012;Chowdhary et al, 2017). However, for the treatment and effective maintenance therapy of chronic aspergillosis, prolonged antifungal therapy is needed (Godet et al, 2016). Thus, further understanding of the molecular mechanism of azole resistance in A. fumigatus in an azole-exposure environment is of great clinical importance and biological interest.…”

Section: Introductionmentioning

confidence: 99%

Uncovering New Mutations Conferring Azole Resistance in the Aspergillus fumigatus cyp51A Gene

et al. 2020

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The opportunistic pathogen Aspergillus fumigatus has developed worldwide resistance to azoles largely through mutations in cytochromeP450 enzyme Cyp51. In this study, we indicated that in vitro azole situation results in emergence of azole-resistant mutations. There are previously identified azole-resistant cyp51A mutations (M220K, M220I, M220R, G54E and G54W mutations) and we successfully identified in this study two new mutations (N248K/V436A, Y433N substitution) conferring azole resistance among 18 independent stable azole-resistant isolates. The Galleria mellonella model of A. fumigatus infection experiment verified that Cyp51A mutations N248K/V436A and Y433N reduce efficacy of azole therapy. In addition, a predicted Cyp51A 3D structural model suggested that Y433N mutation causes the reduced affinities between drug target Cyp51A and azole antifungals. This study suggests that drug selection pressure make it possible to isolate unidentified cyp51A mutations conferring azole resistance in A. fumigatus.

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“…Radiographic monitoring with low-dose CT without contrast or chest radiographs are often used. Decrease in cavity and pleural thickness and the loss of fungal ball on imaging paralleled clinical response the most [71].…”

Section: Treatmentmentioning

confidence: 84%

Advances in the Diagnosis and Management of Pulmonary Aspergillosis

Gao

Soubani

2020

Advances in Respiratory Medicine

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Aspergillus is a mould that is ubiquitous in nature and may lead to a variety of infectious and allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients appear to be at an increased risk as well. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic pulmonary aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Recently, the European Society for Clinical Microbiology and Infectious Diseases provided a more robust sub-classification of this entity that allows for a straightforward approach to diagnosis and management. Allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. It also details the role of noninvasive tests in the diagnosis of Aspergillus related lung diseases and advances in the management of these disorders.

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CT Imaging Assessment of Response to Treatment in Chronic Pulmonary Aspergillosis

Cited by 66 publications

References 18 publications

Post tuberculosis treatment infectious complications

Post tuberculosis treatment infectious complications

Uncovering New Mutations Conferring Azole Resistance in the Aspergillus fumigatus cyp51A Gene

Advances in the Diagnosis and Management of Pulmonary Aspergillosis

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