Chest
Clinical Investigations: PediatricsAllergic Bronchopulmonary Aspergillosis in Patients With Cystic Fibrosis
Section snippets
Patients and Methods
During a 6-month period in 1985, we reviewed records of 236 patients with CF who were diagnosed and followed up at the Duke CF center. These patients had blood counts, chest x-ray films, and sputum or throat swab specimens submitted for culture as part of their routine care. The sputum specimens were plated on routine blood agar nonenhanced media. Spirometric testing was performed on patients old enough to cooperate and forced vital capacity, FEV1, and mean forced expiratory flow during the
Results
The patients ranged in age from 1 to 41 years, with a mean age of 14.5 years. All patients were white; there were 11 male and only 4 female patients, with a ratio of 2.7:1. Their Shwachman-Kulczycki (S-K) scores13 ranged from 35 to 100 with a mean of 78.5. Sixty patients (25 percent of the population) were found to have colonies of A fumigatus, as evidenced by growth on the sputum culture. These patients were significantly older (p < 0.0002) and had more severe disease, as assessed by a lower
Discussion
Cystic fibrosis is an autosomal recessive disease involving dysfunction of the exocrine glands. One major target organ is the lung where the presence of thick tenacious secretions favor the growth of certain microorganisms, especially Pseudomonas aeruginosa and Staphylococcus aureus. The secretory products of these microorganisms along with the inflammatory response initiated by their presence result in lung damage involving predominantly the upper lobe.
Allergic bronchopulmonary aspergillosis
ACKNOWLEDGMENT
The help of David F. Merten, M.D., in reviewing the radiologic findings is greatly appreciated.
References (26)
- et al.
Association of allergic bronchopulmonary aspergillosis and cystic fibrosis
J Allergy Clin Immunol
(1982) - et al.
Allergic bronchopulmonary aspergillosis in cystic fibrosis
J Allergy Clin Immunol
(1984) - et al.
Allergic bronchopulmonary aspergillosis and the evaluation of the patient with asthma
J Allergy Clin Immunol
(1988) - et al.
Precipitating antibodies to Aspergillus fumigatus in cystic fibrosis
Lancet
(1967) - et al.
Serum IgE in clinical immunology and allergy
J Allergy Clin Immunol
(1972) - et al.
Serum IgE as an important aid in management of allergic bronchopulmonary aspergillosis
J Allergy Clin Immunol
(1984) - et al.
Specific serum immunopatterns in clinical phases of allergic bronchopulmonary aspergillosis
J Allergy Clin Immunol
(1992) - et al.
Variability of parameters of allergic bronchopulmonary aspergillosis in patients with cystic fibrosis
J Allergy Clin Immunol
(1991) - et al.
Bronchopulmonary aspergillosis—a review and a report of eight new cases
Thorax
(1952) - et al.
Pulmonary aspergillosis: a survey of its occurrence in patients with chronic lung disease and a discussion of the significance of diagnostic tests
Thorax
(1968)
Allergic bronchopulmonary aspergillosis in corticosteroid-dependent asthmatics
J Allergy Clin Immunol
Transient pulmonary infiltrations in cystic fibrosis due to allergic aspergillosis
Thorax
Allergic Aspergillus in cystic fibrosis
Mod Probi Pediatr
Cited by (127)
The presence of Aspergillus fumigatus is associated with worse respiratory quality of life in cystic fibrosis
2020, Journal of Cystic FibrosisCitation Excerpt :To our knowledge, our study is the first investigation of the relationship between Af and patient-reported outcomes in a general CF population. Lung function decline, pulmonary exacerbations, and radiographic findings of lung disease have been the outcomes of previous studies examining the clinical effects of Aspergillus species [4,24–29]. Aaron et al. conducted a randomized, placebo-controlled trial of itraconazole for chronic Af in CF patients which did not find a difference in change in respiratory domain score of CFQ-R and other clinical endpoints over 24-week treatment period.
What is the clinical significance of filamentous fungi positive sputum cultures in patients with cystic fibrosis?
2013, Journal of Cystic FibrosisCitation Excerpt :Two older retrospective studies in German [12] and French children [10] found no associations between AC and clinical parameters like FEV1, Shwachman–Kulczycki (S–K) scores and radiological scores of lung disease. In contrast to these studies, two reports from US CF centres reported lower S–K and higher chest radiograph scores in patients who had Aspergillus spp. isolated from the airways [9,11]. Both these studies assigned patients to the Aspergillus spp. group on the basis of a single isolate which does not constitute colonisation and these studies are not directly comparable to the more recent studies stipulating repeated isolation for a diagnosis of AC.
Aspergillus fumigatus colonization in cystic fibrosis: Implications for lung function?
2011, Clinical Microbiology and InfectionCitation Excerpt :Filamentous fungi such as Aspergillus fumigatus are also commonly found in respiratory secretions of patients. Reported prevalence rates of colonization in patients with CF vary, ranging from 6% to 58% [2–11]. The variation in the reported prevalence has been hypothesized to be attributable to the age of patients and climatic conditions [8].
Antifungal therapies for allergic bronchopulmonary aspergillosis in people with cystic fibrosis
2022, Cochrane Database of Systematic ReviewsNatural product-based nanomedicine applied to fungal infection treatment: A review of the last 4 years
2022, Phytotherapy ResearchClinical Impact of Aspergillus fumigatus in Children with Cystic Fibrosis
2022, Microorganisms