Aspergillus Airway Colonization and Invasive Disease After Lung Transplantation

Cahill, Barbara C.; Hibbs, Jonathan R.; Savik, Kay; Juni, Billie A.; Dosland, Beth M.; Edin-Stibbe, Cheryl; Hertz, Marshall I.

doi:10.1378/chest.112.5.1160

Cited by 211 publications

(172 citation statements)

References 14 publications

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“…after LT ranges from 6% to 17% (1,2,3), with a reported 50-100% mortality rate (2,3). Given typically found in the distal diaphysis of long bones during an early stage and may extend to the metaphysis or even epiphysis in severe cases (4,10).…”

Section: Aspergillus Infection Is One Of the Many Serious Opportunistmentioning

confidence: 99%

Periostitis Secondary to Prolonged Voriconazole Therapy in Lung Transplant Recipients

Wang¹,

Wang

Altman

et al. 2009

American Journal of Transplantation

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We report five cases of possible drug-induced periostitis associated with long-term use of voriconazole therapy after lung transplantation (LT). The diagnosis of periostitis was made by the documentation of bone pain, elevation of serum alkaline phosphatase and characteristic findings on radionuclide bone imaging in the absence of any identifiable rheumatologic disease. This periostitis appears similar to hypertrophic osteoarthopathy (HOA) but does not meet all criteria for HOA. In all patients, the symptoms resolved rapidly after discontinuation of voriconazole therapy. Awareness of this potential syndrome, which manifests as bone pain, elevated serum alkaline phosphatase and a bone scan suggestive of periostitis, is necessary in LT recipients on long-term voriconazole.

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Section: Aspergillus Infection Is One Of the Many Serious Opportunistmentioning

confidence: 99%

Periostitis Secondary to Prolonged Voriconazole Therapy in Lung Transplant Recipients

Wang¹,

Wang

Altman

et al. 2009

American Journal of Transplantation

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“…Severe allergic responses are observed in patients with allergic bronchopulmonary aspergillosis, a syndrome characterized by A. fumigatus colonization, recurrent episodes of wheezing, mucus production, pulmonary infiltrates, and elevated levels of serum IgE, bronchiectasis, and fibrotic lung disease (3,8,9). Finally, invasive pulmonary aspergillosis is characterized by profound destructive fungal growth in the airways (10). Although the development of invasive aspergillosis is a complication of immunosuppression and/or neutropenia (11), an explanation for the persistence of A. fumigatus in the lungs of immunocompetent individuals sensitized to this fungus is not presently known.…”

mentioning

confidence: 99%

Antifungal and Airway Remodeling Roles for Murine Monocyte Chemoattractant Protein-1/CCL2 During Pulmonary Exposure toAsperigillus fumigatusConidia

Blease¹,

Mehrad

Lukacs³

et al. 2001

The Journal of Immunology

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Asperigillus fumigatus spores or conidia are quickly eliminated from the airways of nonsensitized individuals but persist in individuals with allergic pulmonary responsiveness to fungus. A. fumigatus-induced allergic airway disease is characterized by persistent airway hyperreactivity, inflammation, and fibrosis. The present study explored the role of CCR2 ligands in the murine airway response to A. fumigatus conidia. Nonsensitized and A. fumigatus-sensitized CBA/J mice received an intratracheal challenge of A. fumigatus conidia, and pulmonary changes were analyzed at various times after conidia. Whole lung levels of monocyte chemoattractant protein-1 (MCP-1/CCL2), but neither MCP-3/CCL7 nor MCP-5/CCL12, were significantly elevated at days 3 and 7 after conidia in nonsensitized mice. MCP-1/CCL2 was significantly increased in lung samples from A. fumigatus-sensitized mice at days 14 and 30 after a conidia challenge. Administration of anti-MCP-1/CCL2 antiserum to nonsensitized mice for14 days after the conidia challenge attenuated the clearance of conidia and significantly increased airway hyperreactivity, eosinophilia, and peribronchial fibrosis compared with nonsensitized mice that received conidia and normal serum. Adenovirus-directed overexpression of MCP-1/CCL2 in A. fumigatus-sensitized mice markedly reduced the number of conidia, airway inflammation, and airway hyperresponsiveness at day 7 after the conidia challenge in these mice. Immunoneutralization of MCP-1/CCL2 levels in A. fumigatus-sensitized mice during days14–30 after the conidia challenge did not affect the conidia burden but significantly reduced airway hyperreactivity, lung IL-4 levels, and lymphocyte recruitment into the airways compared with the control group. These data suggest that MCP-1/CCL2 participates in the pulmonary antifungal and allergic responses to A. fumigatus conidia.

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“…Aspergillus versicolor and Aspergillus sydowii are rare causes of fungal sinusitis. Though these rarer isolates are less pathogenic, they may cause invasive disease in severely immunocompromised patients [11].…”

Section: Discussionmentioning

confidence: 99%

Fungal Rhinosinusitis: Report of uncommon Aspergillus species as etiological agents

Nagarajan¹,

Premamalini²,

Kindo³

et al. 2014

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. We hereby report three cases of fungal sinusitis caused by uncommon Aspergillus such as A. versicolor and A. sydowii. Case 1 was a 40-year-old female came with complaints of nasal block and nasal discharge for past one and a half years with history of previous nasal surgery. Her computed tomography (CT) scan of paranasal sinus (PNS) showed bilateral ethmoidal sinusitis. Case 2 was a 43-year-old male known asthmatic presented with complaints of nasal block for last five years, was diagnosed to have bilateral sinonasal polyposis by anterior rhinoscopy. Case 3 was a 17-year-old female known asthmatic presented with headache, nasal discharge and frequent sneezing for last six months. Her CT PNS showed left side deviated nasal septum with left side pan sinusitis along with right frontal sinusitis. All the three patients underwent functional endoscopic sinus surgery (FESS). The material was sent to the microbiology laboratory for fungal culture and potassium hydroxide mount. Speciation by slide culture was not conclusive. Hence, molecular methods were opted for speciation. Conclusion: Reporting of these cases will ensure awareness among the microbiologists about the not so common Aspergilli as a cause of fungal sinusitis. The need of molecular methods for speciation has also been emphasized here as it is difficult to speciate these Aspergilli using routine conventional methods. IJCRI publishes

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Aspergillus Airway Colonization and Invasive Disease After Lung Transplantation

Cited by 211 publications

References 14 publications

Periostitis Secondary to Prolonged Voriconazole Therapy in Lung Transplant Recipients

Periostitis Secondary to Prolonged Voriconazole Therapy in Lung Transplant Recipients

Antifungal and Airway Remodeling Roles for Murine Monocyte Chemoattractant Protein-1/CCL2 During Pulmonary Exposure toAsperigillus fumigatusConidia

Fungal Rhinosinusitis: Report of uncommon Aspergillus species as etiological agents

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