Invasive pulmonary aspergillosis: effects of early resection in a neutropenic rat model

Habicht, James; Preiß, M.; Passweg, Jakob; Dalquen, Peter; Matt, Peter; Adler, Hildegard; Frei, Reno; Zerkowski, H.–R.

doi:10.1016/s1010-7940(02)00467-0

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…None of them had undergone lung resection. We and others have previously shown that early lung resection (lobectomy or wedge resection) combined with antifungal therapy is safe, effective, and diagnostic in neutropenic patients suspected of having IPA (1,6,7,8,16,18,26). A positive fungal culture allows for exact microbiological determination of the fungal species and for susceptibility testing.…”

Section: Case Reportmentioning

confidence: 99%

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Use of Lung Resection and Voriconazole for Successful Treatment of Invasive Pulmonary Aspergillus ustus Infection

Azzola

Passweg²,

Habicht³

et al. 2004

J Clin Microbiol

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Invasive pulmonary aspergillosis (IPA) is a common infection in neutropenic patients and is associated with high mortality. Aspergillus ustus is a species that has only rarely been implicated in human disease. All reported cases of IPA due to A. ustus have been fatal. Here, we describe a case of invasive pulmonary A. ustus infection successfully treated with lung resection and voriconazole. A 43-year-old man with acute myeloid leukemia underwent two courses of chemotherapy and experienced prolonged neutropenia. Treatment with amphotericin B was given for persistent fever. While he was receiving amphotericin B, a progressive opacity developed in the upper right lobe. Lung tissue obtained through pulmonary wedge resection for histology showed a mold with septate hyphae, consistent with IPA due to Aspergillus. A. ustus was grown in culture. The patient was then treated with voriconazole and remained in remission of the mold infection in spite of additional chemotherapy and a leukemic relapse. In summary, this report describes the successful treatment of invasive pulmonary A. ustus infection by lung resection and antifungal treatment with voriconazole in a neutropenic patient.

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Section: Case Reportmentioning

confidence: 99%

“…A definitive diagnosis of IPA requires a biopsy with histology and fungal culture (21). Early surgical resection combined with antifungal therapy is associated with an acceptable low complication risk, allows identification of the microorganism, and appears to improve the prognosis for patients with localized infections (1,6,7,8,16,18,26).…”

mentioning

confidence: 99%

Use of Lung Resection and Voriconazole for Successful Treatment of Invasive Pulmonary Aspergillus ustus Infection

Azzola

Passweg²,

Habicht³

et al. 2004

J Clin Microbiol

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“…A large majority of all the analyzed articles were dedicated to immunopathology of invasive aspergillosis and study of the fungal virulence, e.g., disease transmission, innate and acquired host-response, genes and proteins involved in fungal invasion, susceptibility to infection: 61.9% addressed this topic vs. 36.1 and 9.3% which were rather devoted to pre-clinical therapy [pharmacology/pharmacokinetics/toxicology, and also several vaccine assays (Clemons et al, 2014) and role of surgery (Habicht et al, 2002)], and to diagnosis/imaging approaches (Yang et al, 2009), respectively. Of note, the analyzed articles frequently covered several research fields at a time: for instance, 10 manuscripts dealt with both diagnosis/imaging and pre-clinical therapy simultaneously, 13 overlapped both diagnosis/imaging and immune-pathophysiology/virulence, and 47 addressed therapeutic and immuno-pathophysiology/virulence concerns within the same studies (Supplementary Material 1).…”

Section: Resultsmentioning

confidence: 99%

Rodent Models of Invasive Aspergillosis due to Aspergillus fumigatus: Still a Long Path toward Standardization

Désoubeaux

Cray

2017

Front. Microbiol.

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Invasive aspergillosis has been studied in laboratory by the means of plethora of distinct animal models. They were developed to address pathophysiology, therapy, diagnosis, or miscellaneous other concerns associated. However, there are great discrepancies regarding all the experimental variables of animal models, and a thorough focus on them is needed. This systematic review completed a comprehensive bibliographic analysis specifically-based on the technical features of rodent models infected with Aspergillus fumigatus. Out the 800 articles reviewed, it was shown that mice remained the preferred model (85.8% of the referenced reports), above rats (10.8%), and guinea pigs (3.8%). Three quarters of the models involved immunocompromised status, mainly by steroids (44.4%) and/or alkylating drugs (42.9%), but only 27.7% were reported to receive antibiotic prophylaxis to prevent from bacterial infection. Injection of spores (30.0%) and inhalation/deposition into respiratory airways (66.9%) were the most used routes for experimental inoculation. Overall, more than 230 distinct A. fumigatus strains were used in models. Of all the published studies, 18.4% did not mention usage of any diagnostic tool, like histopathology or mycological culture, to control correct implementation of the disease and to measure outcome. In light of these findings, a consensus discussion should be engaged to establish a minimum standardization, although this may not be consistently suitable for addressing all the specific aspects of invasive aspergillosis.

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“…In this setting, a lobectomy, a segmentectomy, or a wedge resection, depending on the location and size of the aspergillosis lesion may be required [102]. Surgical resection of such lesions appears to improve the outcome [4,[104][105][106][107][108]. However, surgical treatment alone is rarely indicated because the infection is usually bilateral and multifocal.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Invasive Pulmonary Aspergillosis in Acute Leukemia: Current Issues for Pathogenesis, Diagnosis and Treatment

Ali¹,

Özçelik

2006

CRMR

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Invasive pulmonary aspergillosis (IPA) is a frequently life-threatening fungal infection that complicates acute leukemia patients following conventional chemotherapy and bone marrow transplantation. The mortality rate reaches 50% in leukemic patients during chemotherapy-induced neutropenia and can exceed 90% in bone marrow transplantation patients. Despite advances in antimicrobial therapy and supportive care, IPA remains a major clinical problem in patients with acute leukemia. Current issues for IPA in adults are reviewed.

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Invasive pulmonary aspergillosis: effects of early resection in a neutropenic rat model

Abstract: In this rat model of localized invasive pulmonary aspergillosis effects of early resection on survival could be demonstrated only in animals not receiving amphotericin B treatment.

Cited by 9 publications

References 23 publications

Use of Lung Resection and Voriconazole for Successful Treatment of Invasive Pulmonary Aspergillus ustus Infection

Use of Lung Resection and Voriconazole for Successful Treatment of Invasive Pulmonary Aspergillus ustus Infection

Rodent Models of Invasive Aspergillosis due to Aspergillus fumigatus: Still a Long Path toward Standardization

Invasive Pulmonary Aspergillosis in Acute Leukemia: Current Issues for Pathogenesis, Diagnosis and Treatment

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