Aspergilloma in a pulmonary hydatid cyst: a case report

Bal, Amanjit; Bagai, Maneesh; Mohan, Harsh; Dalal, Usha

doi:10.1111/j.1439-0507.2008.01495.x

Cited by 14 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…TB, NTM infection and ABPA remain the predominant risk factors for development of CPA, with COPD, prior pneumothorax or treated lung cancer also relatively common [26,62]. Fibrocystic sarcoidosis [19], ankylosing spondylitis, pneumoconiosis [63] and progressive massive fibrosis in silicosis [64,65] may also be implicated [40,55,[66][67][68][69]. Changes secondary to the Aspergillus infection itself range from the typical appearance of a fungus ball within a lung cavity (single or simple aspergilloma) to complex pleuroparenchymal features that are related to a progressive destructive cavitary disease [61].…”

Section: Imaging Findingsmentioning

confidence: 99%

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Denning¹,

Cadranel²,

et al. 2015

View full text Add to dashboard Cite

Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ∼240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease. Subacute invasive pulmonary aspergillosis (formerly called chronic necrotising pulmonary aspergillosis) is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. Few clinical guidelines have been previously proposed for either diagnosis or management of CPA. A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of Aspergillus infection (microscopy or culture from biopsy) or an immunological response to Aspergillus spp. and exclusion of alternative diagnoses, all present for at least 3 months. Aspergillus antibody (precipitins) is elevated in over 90% of patients. Surgical excision of simple aspergilloma is recommended, if technically possible, and preferably via video-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, arrest haemoptysis and prevent progression. Careful monitoring of azole serum concentrations, drug interactions and possible toxicities is recommended. Haemoptysis may be controlled with tranexamic acid and bronchial artery embolisation, rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. Patients with single Aspergillus nodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up. @ERSpublications ERS and ESCMID guideline for the management of chronic pulmonary aspergillosis released

show abstract

Section: Imaging Findingsmentioning

confidence: 99%

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Denning¹,

Cadranel²,

et al. 2015

View full text Add to dashboard Cite

show abstract

“…В качестве фоновых могут высту пать различные заболевания [62]. Преобладающими факторами риска являются туберкулез, НТМ, АБЛА; также часто встречаются ХОБЛ, предшествующие пневмоторакс или леченый рак легкого [26,62], сар коидоз в стадии фиброза [19], анкилозирующий спондилит, пневмокониоз [63] и силикоз с прогрес сирующим массивным фиброзом [40,55,[64][65][66][67][68][69]. Из менения, связанные непосредственно с инфекцией Aspergillus spp., могут иметь разные проявления -от типичных признаков «грибкового шара» внутри полости в легком (одиночная или простая аспергил лема) до выраженного плевропаренхиматозного по ражения с прогрессирующей деструкцией легочной ткани [61].…”

Section: визуализационная диагностикаunclassified

Diagnosis and treatment of chronic pulmonary aspergillosis: clinical guidelines of European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society

Denning¹,

Cadranel²,

Ader³

et al. 2017

Pulʹmonologiâ (Mosk.)

View full text Add to dashboard Cite

Chronic pulmonary aspergillosis (CPA) is infrequent respiratory disease which is difficult for diagnosis and can complicate other respiratory diseases and conditions. Currently, there are about 240,000 CPA patients in Europe. The most prevalent variant of CPA is chronic cavitary pulmonary aspergillosis (CCPA) which could progress to chronic fibrosing pulmonary aspergillosis (CFPA) when is untreated. Aspergillus nodules and single aspergilloma are less frequent clinical variants of this disease. All clinical variants of aspergillosis could be found in nonimmunocompromised patients with different underlying pulmonary disorders. Subacute invasive pulmonary aspergillosis, which was referred to as chronic necrotising pulmonary aspergillosis, is the most rapidly progressive clinical variant of the infection (< 3 months); it is typically diagnosed in moderately immunocompromised patients and should be treated as invasive aspergillosis. Diagnosis and management of CPA patients were previously described in sporadic guidelines. Due to this, expert group have been convened to develop clinical, radiological and microbiological guidelines. Diagnosis of CPA requires a combination of the following criteria existing for 3 months or more: one or more cavities in the lungs with or without fungal mass inside or nodules found on radiological examination; direct evidence of Aspergillus infection (using microscopic examination or biopsy culturing) or immunological response to Aspergillus spp. and exclusion of alternative diseases. Antibodies against Aspergillus spp. (precipitins) are increased in > 90% of patients. Aspergilloma should be resected if technically possible; videoassisted thoracic surgery is preferable. Chronic cavitary pulmonary aspergillosis requires longterm oral antifungal therapy to improve the patients' health and respiratory symptoms, to arrest haemoptysis and prevent the disease progression. Azole serum concentration and drug interaction should be thoroughly monitored to avoid toxic effects. Haemoptysis could be arrested using therapy with tranexamic acid or bronchial artery embolization; surgical resection of the lung is rarely required. Haemoptysis could indicate therapeutic failure and / or resistance to antifungals. Patients with a single Aspergillus nodule need antifungal therapy only if surgical resection is impossible. Antifungal therapy could be beneficial in patients with multiple Aspergillusis nodules; these patients need careful followup.

show abstract

“…Bu tarzda, hidatik kist kavitesinde aspergillus ile uyumlu fungal kollonizasyon oldukça ender görülen bir durumdur. Bizim bildiğimiz kadarıyla literatürde sadece 9 yayın bulunmaktadır (3)(4)(5)(6)(7)(8)(9)(10)(11). Bildirilen olguların çoğu immün kompetandır, sadece 1'inde diabetes mellitus öyküsü vardır.…”

Section: Olgu Sunumuunclassified

“…Bunlar arasında en sık görülen Aspergilloma; tüberküloz, sarkoidoz, bronşiektazi ve neoplazi gibi hastalıklara bağlı gelişen kaviter lezyonlarda görülür (1,2). Aspergilloma operasyon sonrası oluşan residü kaviter alanlarda da bildirilmekle birlikte hidatid kist kavitesinde kolonizasyon ender görülmektedir (3)(4)(5)(6)(7)(8)(9)(10)(11).…”

Section: Introductionunclassified

Aspergillus colonization of an echinococcal cyst cavity: case report

Gürel¹,

Kargı²,

Ünlü³

et al. 2011

TJPATH

View full text Add to dashboard Cite

Although lungs are common sites for the occurrence of saprophytic or invasive mycosis as well as hydatid cyst, aspergilloma within a hydatid cyst is a rare occurrence.A 36-year-old immunocompetent male presented with hemoptysis episodes of about 1 year duration. Chest X-ray revealed a smooth countered mass lesion located in the upper part of lower lobe of left lung. Surgical enucleation of the cyst wall was performed. Microscopic examination showed that the laminated membranes of hydatid cyst were invaded by septated fungal hyphea oriented with acute angles consistent with aspergillus.Herein, we report such a unique coexistence of hydatid cyst and aspergilloma, and emphasize possible complications depending on the immunostatus of the patient, if the aspergillus colonization is unnoticed in resected cystectomy material.

show abstract

Aspergilloma in a pulmonary hydatid cyst: a case report

Cited by 14 publications

References 0 publications

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Diagnosis and treatment of chronic pulmonary aspergillosis: clinical guidelines of European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society

Aspergillus colonization of an echinococcal cyst cavity: case report

Contact Info

Product

Resources

About