Necrotizing Aspergillosis of Large Airways: CT Findings in Eight Patients

Franquet, T.; Serrano, Félix; Giménez, A.; Rodríguez-Arias, J.M.; Puzo, Carmen

doi:10.1097/00004728-200205000-00004

Cited by 22 publications

(12 citation statements)

References 12 publications

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“…Therefore, it is possible that these lesions were responsible for the death of some mice. Disease confined to large airways, a pattern that is observed less commonly than bronchopneumonia, may result in acute airway obstruction in humans and has been reported after resolution of neutropenia (4,22). However, the presence of more distal lesions in the mice at earlier times after infection (data not shown) and the consistent finding of extensive parenchymal inflammation in which only hyphal remnants were observed suggest that these inflammatory lesions were sufficient to cause death.…”

Section: Discussionmentioning

confidence: 78%

The Pathogenesis of Fatal Outcome in Murine Pulmonary Aspergillosis Depends on the Neutrophil Depletion Strategy

2005

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Aspergillus fumigatus causes invasive disease in severely immunocompromised hosts but is readily cleared when host innate defenses are intact. Animal models for evaluation of therapeutic strategies to combat invasive aspergillosis that closely mimic human disease are desirable. We determined optimal dosing regimens for neutrophil depletion and evaluated the course of infection following aerosol infection in mice by determining survival, organ fungal burden, and histopathology in mice in which neutropenia was induced by three methods, administration of granulocyte-depleting monoclonal antibody RB6-8C5 (MAb RB6), administration of cyclophosphamide, and administration of both agents. Administration of either individual agent resulted in a requirement for relatively high conidial inocula to achieve 100% mortality in both BALB/c and C57BL/6 mice, although the infection appeared to be somewhat more lethal in C57BL/6 mice. Death following induction of neutropenia with MAb RB6 occurred when a relatively low fungal burden was present in the lung and may have been related to the inflammatory response associated with neutrophil recovery. In contrast, administration of both agents reduced the lethal inoculum in each mouse strain by approximately 1 log 10 , and C57BL/6 mice that received both agents had a higher fungal burden and less inflammation in the lung at the time of death than BALB/c mice or mice of either strain that received MAb RB6 alone. Our data suggest that the relationship among fungal burden, inflammation, and death is complex and can be influenced by the immunosuppression regimen, the mouse strain, and the inoculum.

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Section: Discussionmentioning

confidence: 78%

The Pathogenesis of Fatal Outcome in Murine Pulmonary Aspergillosis Depends on the Neutrophil Depletion Strategy

2005

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“…Treatment includes supportive therapy and antimicrobial therapy. 7,12,46 Chronic infections include rhinoscleroma and tuberculosis. Rhinoscleroma is a chronic granulomatous infection by Klebsiella rhinoscleromatis, occurring almost exclusively in tropical regions.…”

Section: Infectionmentioning

confidence: 99%

Appropriate Evaluation of Large Airways Disease With Logical Imaging Sequence

Sirajuddin

Kanne

2012

Clinical Pulmonary Medicine

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Patients with disease of the large airways usually present with nonspecific signs and symptoms such as cough, dyspnea, stridor, and hemoptysis. Although chest radiography is usually the first imaging test performed to evaluate patients with lower respiratory tract symptoms, it has low sensitivity for large airways disease. Multidetector computed tomography (MDCT) has become the imaging test of choice to evaluate patients with known or suspected large airways disease. MDCT can show the morphology and extent of large airways disease and can be used to guide treatment and to reassess patients after therapy. This article reviews techniques for imaging the large airways and illustrates the MDCT findings of a broad range of large airway diseases.

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“…a Posteroanterior chest radiograph and b Computed tomography shows bilateral, ill-defined nodular opacities. A. terreus was isolated from the sputum 73]. Conditions associated with the development of semiinvasive pulmonary aspergillosis include chronic debilitating illness, diabetes mellitus, malnutrition, alcoholism, advanced age, prolonged corticosteroid administration, and chronic obstructive lung disease [72].…”

Section: Fungal Infectionmentioning

confidence: 99%

“…Hemoptysis is seen in only 15% of patients. Diagnosis is often difficult to make because Aspergillus organisms may be present in the sputum or BAL fluid in patients who have colonization of the airways without tissue invasion [72,73]. In clinical practice the diagnosis of semi-invasive aspergillosis is usually based on the presence of multiple positive cultures for Aspergillus, abnormal chest radiograph, and bronchoscopy biopsy specimen consistent with tissue invasion.…”

Section: Fungal Infectionmentioning

confidence: 99%

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High-resolution computed tomography (HRCT) of lung infections in non-AIDS immunocompromised patients

Franquet

2005

Eur Radiol

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Non-AIDS immunocompromised patients are susceptible to infections by a wide range of organisms. In the past several decades, advances in the treatment of cancer, organ transplantation, and immunosuppressive therapy have resulted in large numbers of patients who develop abnormalities in their immune system. Moreover, mildly impaired host immunity as it occurs in chronic debilitating illness, diabetes mellitus, malnutrition, alcoholism, advanced age, prolonged corticosteroid administration, and chronic obstructive lung disease have also been regarded as predisposing factors of pulmonary infections. Imaging plays a crucial role in the detection and management of patients with pulmonary infectious diseases. When pulmonary infection is suspected, knowledge of the varied radiographic manifestations will narrow the differential diagnosis, helping to direct additional diagnostic measures and serving as an ideal tool for follow-up examinations. Combination of pattern recognition with knowledge of the clinical setting is the best approach to pulmonary infection occurring in the immunocompromised patients.

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Necrotizing Aspergillosis of Large Airways: CT Findings in Eight Patients

Abstract: The CT findings of necrotizing bronchial aspergillosis include bronchial wall thickening, which is often nodular, and narrowing of the bronchial lumen, which is often associated with distal atelectasis.

Cited by 22 publications

References 12 publications

The Pathogenesis of Fatal Outcome in Murine Pulmonary Aspergillosis Depends on the Neutrophil Depletion Strategy

The Pathogenesis of Fatal Outcome in Murine Pulmonary Aspergillosis Depends on the Neutrophil Depletion Strategy

Appropriate Evaluation of Large Airways Disease With Logical Imaging Sequence

High-resolution computed tomography (HRCT) of lung infections in non-AIDS immunocompromised patients

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