Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis

Ando, Tsunehiro; Tochigi, Naobumi; Gocho, Kyoko; Moriya, Atsuko; Ikushima, Soichiro; Kumasaka, Takashi; Takemura, Tamiko; Shibuya, Kazutoshi

doi:10.7883/yoken.jjid.2015.028

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…Active movement and rubbing against the cavity wall of an immature and fragile fungus ball might have led to reduction in its size, along with conversion to an invasive form in some portions of the fungus ball. This assumption was supported by a research on pathology, which showed that a fungus ball is fragile and may be broken easily into fragments; also, the cavity and connecting bronchi were observed to be filled by massive inflammatory exudates and necrotic tissues (20).…”

Section: Discussionmentioning

confidence: 86%

Risk factors of severe hemoptysis in patients with fungus ball

Kim¹,

Koo²,

Lim³

et al. 2019

J. Thorac. Dis.

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Background: Hemoptysis is one of the most important complications associated with fungus ball.However, the association of the primary size of the fungus ball and its change with the incidence of hemoptysis was not fully established. This study aims to determine the clinical risk factors of severe hemoptysis and natural course of fungus ball. Methods: A retrospective study on patients with fungus ball was performed. Patients with severe hemoptysis-related events were compared to those without events, and the predictors for severe hemoptysis were investigated by Cox regression analysis. Three subgroups (decreased, stable, and increased) were classified according to the long-term size change, and the severe hemoptysis-free survival duration was analyzed by the Kaplan-Meier survival curve. Results: Among 173 patients, 50 (28.9%) experienced severe hemoptysis-related events. Risk-adjusted analysis revealed that age [hazard ratio (HR), 0.964; 95% confidence interval (CI), 0.939-0.989], bloodtinged sputum [HR, 2.717; 95% CI, 1.513-4.879], and thick wall cavitary fungus balls [HR, 2.332; 95% CI, were significant predictors of severe hemoptysis-related events in patients with fungus ball. However, the baseline size of the fungus ball and its change rate were not independent risk factors for severe hemoptysis-related events. Besides, the decreased group did not have a favorable outcome in severe hemoptysis related to fungus ball. Conclusions: In a tertiary hospital, the incidence of severe hemoptysis-related events in patients with fungus ball was not low and reached 28.9%. Young patients, those with thick wall cavitary fungus ball, and those with complaints of blood-tinged sputum should be considered for early surgical treatment to prevent severe hemoptysis.

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Section: Discussionmentioning

confidence: 86%

Risk factors of severe hemoptysis in patients with fungus ball

Kim¹,

Koo²,

Lim³

et al. 2019

J. Thorac. Dis.

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“…In our CPA patients, specific chest CT findings, like halo sign and air crescent sign, were rarely seen. The rate of pulmonary cavitation (11.90%) is much lower than reported (26, 94.2%) [15, 21]. These 42 CPA patients come from our hospital and only 3 patients have previous tuberculosis.…”

Section: Discussionmentioning

confidence: 69%

Prospective study of the serum Aspergillus-specific IgG, IgA and IgM assays for chronic pulmonary aspergillosis diagnosis

Wang

Zhao

et al. 2019

BMC Infect Dis

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Background Chronic pulmonary aspergillosis (CPA) is an underdiagnosed and misdiagnosed disease and now increasingly recognised. However, the diagnosis of CPA remains challenging. In this study, we aimed to investigate the diagnostic values of serum Aspergillus -specific IgG, IgA and IgM antibodies in patients with CPA. Methods The prospective study was performed at Chinese People’s Liberation Army General Hospital in Beijing, from January 2017 to December 2017. Adult patients with lung lesions presented as cavity, nodule, mass, bronchiectasis or severe fibrotic destruction with at least two lobes in CT imaging were enrolled. One hundred healthy persons were also enrolled as additional controls. The serum levels of Aspergillus -specific IgG, IgA and IgM antibodies and galactomannan (GM) levels were measured simultaneously by plate ELISA kit. Results A total of 202 patients were enrolled in this study, including 42 CPA patients, 60 non-CPA patients and 100 healthy persons. The most common underlying lung diseases in CPA patients were bronchiectasis (28.6%) and COPD (19.0%). The most common symptoms in the CPA patients were cough (76.2%), sputum (71.4%), and fever (45.2%); chest pain (4.8%) was infrequent. Receiver operating characteristic (ROC) curve analysis revealed that the optimal CPA diagnostic cut-off of Aspergillus -specific IgG, IgA and IgM assays and GM test were 89.3 AU/mL, 8.2 U/mL, 73.3 AU/mL and 0.5μg/L, respectively. The serum levels of Aspergillus -specific IgG and IgA in CPA patients were higher than these in non-CPA patients or healthy persons. The sensitivities and specificities of Aspergillus -specific IgG, IgA, IgM tests and GM test were 78.6 and 94.4%, 64.3 and 89.4%, 50.0 and 53.7% and 71.4 and 58.1%, respectively. Conclusions The sensitivity and specificity of serum Aspergillus -specific IgG assay are satisfactory for diagnosing CPA, while the performance of Aspergillus -specific IgA assay is moderate. Aspergillus -specific IgM assay and serum GM test have limited value for CPA diagnosis. Trial registration NCT03027089 . Registered 20 January 2017.

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“…Imaging findings in patients with CPA consist mainly of cavities, fungus balls, pleural thickening and pericavitary consolidation in the upper lobes [4,5]. The treatment of pulmonary aspergillosis diseases is usually conservative management and pharmacotherapy in the form of azole antifungal agents.…”

Section: Discussionmentioning

confidence: 99%

Hydatid disease with Aspergilloma: A unique case report

Sharma

Thakare

Utpat

et al. 2021

Monaldi Arch Chest Dis

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The coexisting presence of hydatid disease with aspergillus colonization is a rare finding. The 20-year-old presented with symptoms of hemoptysis with past history of tuberculosis. On further evaluation, the patient was diagnosed as a case of aspergilloma and managed conservatively. After one year of presenting with similar complaints, the patient was turned out to be hydatid disease with aspergillus colonization on the basis of clinic-radiological and bronchoscopic evaluation. Till now only a few case reports have been reported. We report a unique case report of a similar presentation.

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Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis

Cited by 8 publications

References 27 publications

Risk factors of severe hemoptysis in patients with fungus ball

Risk factors of severe hemoptysis in patients with fungus ball

Prospective study of the serum Aspergillus-specific IgG, IgA and IgM assays for chronic pulmonary aspergillosis diagnosis

Hydatid disease with Aspergilloma: A unique case report

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