The invasive and saprophytic syndromes due toAspergillusspp.

Abstract

Aspergillus spp. produce a wide range of invasive and sapropytic syndromes which may involve any tissue. Within a given tissue or organ the pathology and pathogenesis varies enormously, ranging from angioinvasive disease to noninvasive saprophytic disease. The individual invasive and saprophytic syndromes in which a causative role can be attributed to Aspergillus spp. are detailed specifically with reference to the underlying pathology and pathogenesis, the clinical setting and features, and the manner in which a diagnosis can be established.

Intravenous micafungin versus voriconazole for chronic pulmonary aspergillosis: A multicenter trial in Japan

“…Smith et al showed that tuberculosis sequelae are also a major risk factor in patients with CPA in United Kingdom 23 . Only the Aspergillus antibody test by the Aspergillus immunodiffusion system showed a reasonably high positive rate with 88.6% of all patients, which resembled the previous results by Denning et al 2,5 The common serum antigen detecting tools for invasive Aspergillus infection are not suitable for CPA diagnosis. Renal events 1 (1.9 %) Renal events 1 (1.9 %)…”

“…1,2 Several names of these chronic forms of disease have been proposed: semi-invasive aspergillosis 3 , chronic necrotizing pulmonary aspergillosis (CNPA) 4 , simple or complex aspergilloma, and chronic cavitary and fibrosing pulmonary aspergillosis (CCPA and CFPA). 5 As Hope et al 6 indicated apparently distinct entities do not exist for this syndrome and these forms usually overlap.…”

Pathogenesis and clinical features of chronic pulmonary aspergillosis – Is it possible to distinguish CNPA and CCPA clinically?

“…Although we respect and follow the original definition of CNPA and the concept of CCPA, there is a limitation to distinguishing these two entities in actual clinical settings as discussed above. Hope et al indicated that apparent distinct entities do not exist for the CPA subtypes and that these forms usually overlap; therefore, the requirement and importance of the rigorous sub-classifications of CPA are unclear [5]. …”

“…infection. In the last decade, new clinical nomenclature and definition of chronic forms of aspergillosis have been proposed [3][4][5], and recent guidelines from the Infectious Diseases Society of America (IDSA) have indicated 3 major subtypes of chronic forms of pulmonary aspergillosis, namely CNPA (categorized in subacute invasive form of aspergillosis; subacute IPA), chronic cavitary pulmonary aspergillosis (CCPA), and aspergilloma [6]. Aspergilloma was traditionally classified as simple or complex in the surgical literature, and complex aspergilloma is considered CCPA by current IDSA guidelines [6,7].…”

Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis

“…Pathological features of fungal invasion of lung parenchyma have been considered a distinctive feature not only of IPA but also of CNPA (25). Hence, it is difficult to distinguish these conditions by pathological examination of biopsies.…”