Abstract
Aspergillus species are the most frequent cause of fungal infections of the lungs with a broad spectrum of clinical presentations including invasive pulmonary aspergillosis (IPA) and chronic pulmonary aspergillosis (CPA). IPA affects immunocompromised populations, which are increasing in number and diversity with the advent of novel anti-cancer therapies. Moreover, IPA has emerged as a complication of severe influenza and coronavirus disease 2019 in apparently immunocompetent hosts. CPA mainly affects patients with pre-existing lung lesions and is recognised increasingly frequently among patients with long-term survival following cure of tuberculosis or lung cancer. The diagnosis of pulmonary aspergillosis is complex as it relies on the presence of clinical, radiological and microbiological criteria, which differ according to the type of pulmonary aspergillosis (IPA or CPA) and the type of patient population. The management of pulmonary aspergillosis is complicated by the limited number of treatment options, drug interactions, adverse events and the emergence of antifungal resistance.
Abstract
The clinical spectrum of pulmonary aspergillosis has broadened with the recognition of novel patient populations at risk and the emergence of resistance, which poses important diagnostic and therapeutic challenges for clinicians https://bit.ly/3R6Cf6Z
Footnotes
Number 7 in the Series “Respiratory infections” Edited by Antoni Torres and Michael S. Niederman
Provenance: Commissioned article, peer reviewed.
Previous articles in this series: No. 1: Kumar K, Daley CL, Griffith DE, et al. Management of Mycobacterium avium complex and Mycobacterium abscessus pulmonary disease: therapeutic advances and emerging treatments. Eur Respir Rev 2022; 31: 210212. No. 2: Cilloniz C, Luna CM, Hurtado JC, et al. Respiratory viruses: their importance and lessons learned from COVID-19. Eur Respir Rev 2022; 31: 220051. No. 3: Cavallazzi R, Ramirez JA. How and when to manage respiratory infections out of hospital. Eur Respir Rev 2022; 31: 220092. No. 4: Reynolds D, Burnham JP, Vazquez Guillamet C, et al. The threat of multidrug-resistant/extensively drug-resistant Gram-negative respiratory infections: another pandemic. Eur Respir Rev 2022; 31: 220068. No. 5: Puerta-Alcalde P, Garcia-Vidal C. Non-Aspergillus mould lung infections. Eur Respir Rev 2022; 31: 220104. No. 6: Al-Tawfiq JA, Kim H, Memish ZA. Parasitic lung diseases. Eur Respir Rev 2022; 31: 220093.
Conflict of interest: F. Lamoth has research funding from Gilead, MSD, Pfizer and Novartis, and has participated in Advisory boards for Gilead, MSD and Pfizer. All contracts were made with and fees paid to his institution (CHUV).
Conflict of interest: T. Calandra has participated in advisory boards or consulted for Menarini, Shinogi, Cytosorbent, ThermoFisher and GE Healthcare for projects unrelated to the submitted work and on data safety monitoring boards for Cidara and Novartis. All contracts were made with and fees paid to his institution (CHUV).
This article has an editorial commentary: https://doi.org/10.1183/16000617.0150-2022
- Received June 15, 2022.
- Accepted September 18, 2022.
- Copyright ©The authors 2022
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