Advances in the diagnosis and management of pulmonary aspergillosis

被引:22
作者
Gao, Yuqing [1 ]
Soubani, Ayman [1 ]
机构
[1] Wayne State Univ, Sch Med, Div Pulm Crit Care & Sleep Med, Detroit, MI 48202 USA
关键词
asperilus; invasive pulmonary aspergillosis; ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS; CRITICALLY-ILL PATIENTS; INVASIVE FUNGAL-INFECTIONS; BRONCHOALVEOLAR LAVAGE; GALACTOMANNAN ANTIGEN; RANDOMIZED-TRIAL; CYSTIC-FIBROSIS; ANTIFUNGAL THERAPIES; GENE-MUTATIONS; ITRACONAZOLE;
D O I
10.5603/ARM.2019.0061
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Aspergillus is a mould that is ubiquitous in nature and may lead to a variety of infectious and allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients appear to be at an increased risk as well. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic pulmonary aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Recently, the European Society for Clinical Microbiology and Infectious Diseases provided a more robust sub-classification of this entity that allows for a straightforward approach to diagnosis and management. Allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. It also details the role of noninvasive tests in the diagnosis of Aspergillus related lung diseases and advances in the management of these disorders.
引用
收藏
页码:231 / 243
页数:13
相关论文
共 113 条
  • [1] Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria
    Agarwal, R.
    Chakrabarti, A.
    Shah, A.
    Gupta, D.
    Meis, J. F.
    Guleria, R.
    Moss, R.
    Denning, D. W.
    [J]. CLINICAL AND EXPERIMENTAL ALLERGY, 2013, 43 (08) : 850 - 873
  • [2] Agarwal R, 2009, INT J TUBERC LUNG D, V13, P936
  • [3] Allergic bronchopulmonary aspergillosis - Lessons from 126 patients attending a chest clinic in north India
    Agarwal, Ritesh
    Gupta, Dheeraj
    Aggarwal, Ashutosh N.
    Behera, Digamber
    Jindal, Surinder K.
    [J]. CHEST, 2006, 130 (02) : 442 - 448
  • [4] Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis - An analysis of 155 patients
    Agarwal, Ritesh
    Gupta, Dheeraj
    Aggarwal, Ashutosh N.
    Saxena, Akshay K.
    Chakrabarti, Arunaloke
    Jindal, Surinder K.
    [J]. CHEST, 2007, 132 (04) : 1183 - 1190
  • [5] A Randomized Trial of Itraconazole vs Prednisolone in Acute-Stage Allergic Bronchopulmonary Aspergillosis Complicating Asthma
    Agarwal, Ritesh
    Dhooria, Sahajal
    Sehgal, Inderpaul Singh
    Aggarwal, Ashutosh N.
    Garg, Mandeep
    Saikia, Biman
    Behera, Digambar
    Chakrabarti, Arunaloke
    [J]. CHEST, 2018, 153 (03) : 656 - 664
  • [6] A randomised trial of glucocorticoids in acute-stage allergic bronchopulmonary aspergillosis complicating asthma
    Agarwal, Ritesh
    Aggarwal, Ashutosh N.
    Dhooria, Sahajal
    Sehgal, Inderpaul Singh
    Garg, Mandeep
    Saikia, Biman
    Behera, Digambar
    Chakrabarti, Arunaloke
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2016, 47 (02) : 490 - 498
  • [7] Allergic Bronchopulmonary Aspergillosis
    Agarwal, Ritesh
    [J]. CHEST, 2009, 135 (03) : 805 - 826
  • [8] Clinical profile and surgical outcome for pulmonary aspergilloma: A single center experience
    Akbari, JG
    Varma, PK
    Neema, PK
    Menon, MU
    Neelakandhan, KS
    [J]. ANNALS OF THORACIC SURGERY, 2005, 80 (03) : 1067 - 1072
  • [9] Invasive pulmonary aspergillosis in patients with influenza infection: report of two cases and systematic review of the literature
    Alshabani, Khaled
    Haq, Athar
    Miyakawa, Ryo
    Palla, Mohan
    Soubani, Ayman O.
    [J]. EXPERT REVIEW OF RESPIRATORY MEDICINE, 2015, 9 (01) : 89 - 96
  • [10] Diagnostic Accuracy of PCR Alone Compared to Galactomannan in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis: a Systematic Review
    Avni, Tomer
    Levy, Itzhak
    Sprecher, Hannah
    Yahav, Dafna
    Leibovici, Leonard
    Paulf, Mical
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 2012, 50 (11) : 3652 - 3658