Invasive Pulmonary Aspergillosis

Abstract

Background: Invasive pulmonary aspergillosis usually occurs in immunocompromised patients. Mild abnormality of host defence is usually present in the chronic necrotising form of the disease. Acute aspergillus pneumonia usually affects patients who are seriously immunocompromised. Objectives: The purpose of the study was to highlight the possibility of occurrence of invasive pulmonary aspergillosis also in patients with mild abnormality of host defence. Methods: In a retrospective study 6 patients were analysed. The inclusion criterion was evidence of Aspergillus sp. invasion in lung tissue. Lung tissue was obtained by biopsy or post mortem examination. Results: There were 4 patients with acute aspergillus pneumonia. Two of them were severely immunocompromised – one with dermatomyositis, who was treated with high doses of corticosteroids and methotrexate, and the other with undiscovered miliary tuberculosis, who was treated for myelodysplastic syndrome instead with low doses of corticosteroids. The other 2 had mild immunosuppression: one was suffering from sarcoidosis and was treated with low doses of corticosteroids, the other had dilated cardiomyopathy, renal insufficiency and diabetes mellitus. The two patients with chronic necrotising pulmonary aspergillosis had mild abnormality of host defence: one had reactivation of tuberculosis and diabetes mellitus, the other had inactive tuberculosis and aspergilloma. Conclusions: Invasive pulmonary aspergillosis must be considered also in patients with mild immunosuppression and pulmonary infiltrates which do not respond to conventional treatment with antibiotic chemotherapy. The key to the diagnosis of invasive pulmonary aspergillosis is the histopathological demonstration of fungal invasion in lung tissue.

In vitro Protease Inhibition and Cytotoxicity of Aspergillus fumigatus Biomolecules Secreted under Long-Term Aerated Conditions

“…It is shown that A. fumigatus CF expressed a high cytotoxicity on murine macrophages under highly aerated conditions 32. However, in our study cytotoxic effect was expressed by CFs obtained on day 6 and condition with 20% O 2 , while other study showed cytotoxicity with A. fumigatus CF obtained after 15 h 32. The samples obtained during short-term fermentation (day 1 and 3) did not express a significant cytotoxicity in this study.…”

“…Our data demonstrated significant inhibition of cell proliferation when extracts after prolonged aerated conditions were used ( A. fumigatus CF AE6) (Figure 2). It is shown that A. fumigatus CF expressed a high cytotoxicity on murine macrophages under highly aerated conditions 32. However, in our study cytotoxic effect was expressed by CFs obtained on day 6 and condition with 20% O 2 , while other study showed cytotoxicity with A. fumigatus CF obtained after 15 h 32.…”

Successful Management of Invasive Pulmonary Nocardiosis and Aspergillosis in a Patient with T-Cell Lymphoma: A Case Report

“…However, the diagnosis of IPA can only be confirmed by histological determination of invasion of lung tissue by Aspergillus species or presence of positive cultures for Aspergillus in a sample obtained from a sterile site by an invasive procedure e.g. lung biopsy ( Kristan et al 2002 ; Ascioglu et al 2002 ; Maertens et al 2004). Open lung biopsy has very low morbidity and is recommended to establish the diagnosis of IPA.…”

A Case of Invasive Pulmonary Aspergillosis in an Immunocompetent Patient Diagnosed by EBUS-TBNA, Misdiagnosed as Lung Cancer.

“…Aspergillosis refers to infectious diseases caused by fungi of the genus Aspergillus present in the residential environment, such as the soil and air (1). Invasive pulmonary aspergillosis (IPA) can be a life-threatening infectious disease for immunosuppressed patients receiving chemotherapy or recipients of stem cell transplantation (2). Early diagnosis is very challenging because IPA has similar clinical features to the usual respiratory infections (3).…”