Chest
ReviewsThe Clinical Spectrum of Pulmonary Aspergillosis
Section snippets
Aspergilloma
This is the most common and best-recognized form of pulmonary involvement due to Aspergillus. The aspergilloma (fungal ball) consists of masses of fungal mycelia, inflammatory cells, fibrin, mucus, and tissue debris, usually developing in a preformed lung cavity. Although other fungi may cause the formation of a fungal ball (for example, Zygomycetes and Fusarium), Aspergillus spp (specifically, A fumigatus) are by far the most common etiologic agents.
The true incidence of aspergilloma is not
Chronic Necrotizing Aspergillosis
Also called semi-invasive aspergillosis, this entity was first described in two reports in 1981 and 1982.40,41 Chronic necrotizing aspergillosis (CNA) is an indolent, destructive process of the lung due to invasion by Aspergillus species (usually A fumigatus). This entity is different from aspergilloma in that there is local invasion of the lung tissue, and a preexisting cavity is not needed, although a cavity with a fungal ball may develop in the lung as a secondary phenomenon due to
IPA
The incidence of IPA has been on the rise since it was first described in 1953.45 Groll et al46 documented a rise in the rate of invasive mycoses from 0.4 to 3.1% of all autopsies performed between 1978 and 1992. In addition, invasive aspergillosis increased from 17% of all mycoses found on autopsy at the beginning of the study to 60% at the end of the 14-year study period.
The vast majority of IPA cases are seen in immunocompromised patients. The risk factors are summarized in Table 1.47,48,49,
Allergic Bronchopulmonary Aspergillosis
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus antigens, mostly due to A fumigatus. It is typically seen in patients with long-standing asthma or cystic fibrosis, and it is estimated that 7 to 14% of corticosteroid-dependent asthma patients and 6% of patients with cystic fibrosis meet the diagnostic criteria for ABPA.116,117 The factors leading to ABPA are not clearly understood. It is believed that Aspergillus-specific, IgE-mediated type I
References (144)
Quandary about treatment of aspergillomas persists
Lancet
(1996)- et al.
Hemoptysis and pulmonary aspergilloma: operative versus nonoperative treatment
Ann Thorac Surg
(1978) - et al.
Pulmonary aspergilloma and AIDS: a comparison of HIV-infected and HIV-negative individuals
Chest
(1997) - et al.
Aspergillosis of the lung: an eighteen-year experience
Chest
(1971) - et al.
The surgical treatment of pulmonary aspergillomas
Thorac Cardiovasc Surg
(1977) - et al.
Pulmonary aspergilloma: results of surgical treatment
Thorac Cardiovasc Surg
(1986) - et al.
Pulmonary aspergillosis: an analysis of 41 patients
Ann Thorac Surg
(1976) - et al.
Cavitary lung cancer with an aspergilloma-like shadow
Lung Cancer
(1999) Aspergillus lung disease
Med Clin North Am
(1980)- et al.
Topical treatment of pulmonary aspergilloma by antifungals: relationship between duration of the disease and efficacy of therapy
Chest
(1993)
Itraconazole therapy in aspergillosis: study in 49 patients
J Am Acad Dermatol
Pleuropulmonary aspergilloma: clinical spectrum and results of surgical treatment
Ann Thorac Surg
Surgery for pulmonary aspergillosis
Thorac Cardiovasc Surg
Aspergilloma: a series of 89 surgical cases
Ann Thorac Surg
Chronic necrotizing aspergillosis: approach to management
Chest
Chronic necrotizing pulmonary aspergillosis and pulmonary phycomycosis in cystic fibrosis
Respir Med
Chronic necrotizing pulmonary aspergillosis: pathologic outcome after itraconazole therapy
Mayo Clin Proc
Trends in the postmortem epidemiology of invasive fungal infections at a university hospital
J Infect
Pulmonary complications of bone marrow transplantation
Chest
Invasive aspergillosis in patients with acquired immunodeficiency syndrome: report of 33 cases; French Cooperative Study Group on Aspergillosis in AIDS
Am J Med
Pulmonary aspergillosis in patients with AIDS: clinical and radiographic correlations
Chest
Endobronchial lesions in HIV-infected individuals
Chest
Aspergillus and endobronchial abnormalities in lung transplant recipients
Chest
Significance of isolation of Aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis: results from a three-year prospective study
Am J Med
The use of respiratory-tract cultures in the diagnosis of invasive pulmonary aspergillosis
Am J Med
Invasive pulmonary aspergillosis in acute leukemia: the contribution of CT to early diagnosis and aggressive management
Chest
Role of fiberoptic bronchoscopy in the diagnosis of invasive pulmonary aspergillosis in patients with acute leukemia
Am J Med
Open lung biopsy in patients with acute leukemia
Am J Med
Value of antigen detection in predicting invasive pulmonary aspergillosis
Lancet
NIAID Mycoses Study Group multicenter trial of oral itraconazole therapy for invasive aspergillosis
Am J Med
Invasive aspergillosis
Rev Infect Dis
Serologic monitoring of disease and treatment in a patient with pulmonary aspergilloma
Am J Respir Crit Care Med
Aspergilloma consequent to allergic bronchopulmonary aspergillosis
Am Rev Respir Dis
Aspergilloma and residual tuberculous cavities: the results of a resurvey
Tubercle
Pulmonary aspergillosis complicating ankylosing spondylitis
Radiol Med (Torino)
Clinical evaluation of 61 patients with pulmonary aspergilloma
Intern Med
Cavitary pulmonary cryptococcosis complicated by aspergilloma
Am Rev Respir Dis
Aspergillomas occurring in blastomycotic cavities
Am Rev Respir Dis
What happens to patients with pulmonary aspergilloma? Analysis of 23 cases
Thorax
The spectrum of pulmonary aspergillosis
J Thorac Imaging
Aspergillus in persistent lung cavities after tuberculosis: a report from the Research Committee of the British Tuberculosis Association
Tubercle
Pulmonary aspergilloma: analysis of prognosis in relation to haemoptysis and survey of treatment
Thorax
Pulmonary aspergilloma: diagnostic and therapeutic considerations
Arch Intern Med
Practice guidelines for diseases caused by Aspergillus: Infectious Diseases Society of America
Clin Infect Dis
Pulmonary air meniscus sign
Respiration
Intrathoracic aspergilloma: role of CT in diagnosis and treatment
Radiology
Pulmonary aspergilloma complicating Wegener's granulomatosis [letter]
Scand J Rheumatol
Pulmonary aspergilloma: clinical immunology
Clin Allergy
Intracavitary aspergilloma: transthoracic percutaneous injection of amphotericin gelatin solution
Radiology
Amphotericin B in the treatment of saprophytic forms of pulmonary aspergillosis
Am Rev Respir Dis
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