Pulmonary aspergillus intracavitary colonization (PAIC)

Severo, Luiz Carlos; Geyer, G; Porto, N. S.

doi:10.1007/bf00436504

Cited by 20 publications

(23 citation statements)

References 49 publications

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“…Firstly, the size of Aspergillus niger conidia (6-7 m) and the presence of strong interspore bridges impair Aspergillus niger penetration into the lower respiratory tract. After inhalation, the spores are therefore easily captured and eliminated by the host mucociliary system 13 . Secondly, Aspergillus niger is less thermotolerant than Aspergillus fumigatus, and its ideal temperature for fungal growth is around 30ºC.…”

Section: Discussionmentioning

confidence: 99%

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Aspergillus niger causing tracheobronchitis and invasive pulmonary aspergillosis in a lung transplant recipient: case report

Xavier

Sales

Camargo

et al. 2008

Rev. Soc. Bras. Med. Trop.

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A case of invasive aspergillosis caused by Aspergillus niger in a lung transplant recipient is described. The patient presented hyperglycemia starting postoperatively, with other complications such as cytomegalovirus infection. The associated predisposing factors and other implications are discussed. Aspergillus niger seems to be a fungal species of low virulence that requires the presence of a severely immunosuppressed host to cause invasive disease.Key-words: Aspergillosis. Tracheobronchitis. Aspergillus niger. Lung transplantation.Lung transplantation. RESUMODescreve-se um caso de aspergilose invasiva causada por Aspergillus niger em um paciente transplantado de pulmão com quadros hiperglicêmicos desde o pós-operatório e outras complicações como infecção por citomegalovírus. Os fatores predisponentes associados e outras implicações são discutidos. Aspergillus niger parece ser uma espécie fúngica de baixa virulência, necessitando a presença de um hospedeiro gravemente imunodeprimido para causar doença invasiva. Aspergillus tracheobronchitis and invasive pulmonary aspergillosis are frequent clinical presentations of Aspergillus infections in lung transplant recipients 11 . It has been documented that aspergillosis is associated with at least 9% of the deaths following lung transplant procedures. The vast majority of infections are caused by Aspergillus fumigatus 8 10 , followed by other species such as Aspergillus flavus, Aspergillus terreus and Aspergillus niger. Here, we report the unusual occurrence of Aspergillus niger infection following lung transplantation. The implications of these findings are discussed. Palavras CASE REPORTA 48-year-old woman had undergone right lung transplantation in 1993 due to idiopathic pulmonary fibrosis. Her early postoperative period was marked by the occurrence of hyperglycemia.Acute rejection was suspected five days after the surgical procedure because of oxygen desaturation events. Broad-spectrum antibacterial therapy was started, including amikacin, ceftazidime and vancomycin. She was also started on a three-day course of high-dose methylprednisolone (1,000mg/day). A transbronchial biopsy revealed the presence of hyaline hyphae infiltrating the lung parenchyma. The hyphae were septate, with acute-angle branching, which was consistent with aspergillosis. Lung biopsy culturing revealed growth of Aspergillus niger. This mould was also recovered from sputum and bronchoalveolar lavage, both cultivated on Sabouraud dextrose agar with chloramphenicol at 25ºC. She was put on a combination of itraconazole (400mg daily) and amphotericin B (1.5mg/kg/day), which she took for two months. Further cultures for fungi were all negative.Over the next months, the patient presented cytomegalovirus pneumonia associated with steroid-resistant rejection. She was RELATO DE CASO/CASE REPORT

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Section: Discussionmentioning

confidence: 99%

“…This makes germination difficult in the presence of the human body temperature (~37ºC) 1 . The acidophilic nature of Aspergillus niger (ideal pH 4.5-4.8) is another limiting condition for fungal pathogenicity 13 .…”

Section: Discussionmentioning

confidence: 99%

Aspergillus niger causing tracheobronchitis and invasive pulmonary aspergillosis in a lung transplant recipient: case report

Xavier

Sales

Camargo

et al. 2008

Rev. Soc. Bras. Med. Trop.

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“…The presentation and clinical course of pulmonary fungus ball in the HIV-infected patient differs in several ways from those in the immunocompetent patient 17 . HIV positive patients are particularly susceptible to cavitary lung disease, including pneumatoceles secondary to P. jirovecii pneumonia and tuberculosis, as well as necrotizing bacterial pneumonias 1,8 .…”

Section: Discussionmentioning

confidence: 97%

“…Fungus ball caused by A. fumigatus is a noninvasive form of pulmonary disease that results from a lung fungal colonization. The empty, post-treatment tuberculosis cavity is the main predisposing factor for fungal colonization in most patients and hemoptysis is the only serious complication 17,22 .…”

Section: Introductionmentioning

confidence: 99%

Fungus ball in HIV-infected patients

Guazzelli

Unis

Xavier

et al. 2009

Rev. Inst. Med. trop. S. Paulo

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SUMMARYAspergillus is a phagocyte opportunistic fungus that causes aspergillosis, an unusual disease in patients with AIDS. Six cases of fungal ball in patients with AIDS are reported here. In this group, all patients had hemoptysis and tuberculosis as the underlying lung disease. The diagnosis of pulmonary fungus ball was based on the clinical and radiographic feature, combined with serological and mycological evidence of Aspergillus fumigatus.

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“…(5) The main predisposing factors for aspergilloma are a history of tuberculosis that has been clinically cured, bronchiectasis, emphysematous bullae, bronchial cysts, and cancer. (6)(7)(8) In such aerated spaces, the defense mechanisms (phagocytosis) are impaired, allowing germination of conidia, which aggregate to form fungal colonies in a dynamic process of growth and death of fungal elements, which can result in degeneration of the aspergilloma.…”

Section: Introductionmentioning

confidence: 99%

Bola fúngica por Aspergillus fumigatus em cavidade pleural

et al. 2012

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OBJETIVO: Relatar os casos de 6 pacientes com bola fúngica (BF) na cavidade pleural por Aspergillus fumigatus. MÉTODOS: Entre 1980 e 2009, foram diagnosticados 391 pacientes com BF aspergilar no Complexo Hospitalar Santa Casa de Porto Alegre (RS). O diagnóstico de BF na cavidade pleural foi definido com exames de imagem demonstrando derrame e espessamento pleural com nível líquido; exame micológico direto demonstrando hifas septadas, consistentes com Aspergillus sp.; e cultura positiva para A. fumigatus no espécime cirúrgico da cavidade pleural. RESULTADOS: Dos 391 pacientes estudados, 6 (2%) preencheram os critérios diagnósticos estabelecidos. A média de idade desses 6 pacientes foi de 48 anos (variação, 29-66 anos), e 5 (83%) eram do sexo masculino. As queixas mais frequentes dos pacientes foram tosse, expectoração e hemoptise. Quatro (67%) dos pacientes tinham tuberculose curada. Todos os pacientes realizaram remoção cirúrgica da colonização fúngica, e houve infusão intrapleural com anfotericina B em 4; e 2 pacientes receberam tratamento antifúngico sistêmico v.o. Cinco pacientes melhoraram clinicamente, e um foi a óbito após a cirurgia. CONCLUSÕES: Em pacientes adultos com história de doença pulmonar cavitária ou fístula pleural, deve-se realizar uma investigação criteriosa levando em consideração a infecção fúngica, principalmente BF pulmonar. Portanto, a exploração laboratorial torna-se mais eficiente em relação aos recursos disponíveis para elucidação diagnóstica.

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Pulmonary aspergillus intracavitary colonization (PAIC)

Cited by 20 publications

References 49 publications

Aspergillus niger causing tracheobronchitis and invasive pulmonary aspergillosis in a lung transplant recipient: case report

Aspergillus niger causing tracheobronchitis and invasive pulmonary aspergillosis in a lung transplant recipient: case report

Fungus ball in HIV-infected patients

Bola fúngica por Aspergillus fumigatus em cavidade pleural

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