The role of surgical debridement in different clinical manifestations of invasive aspergillosis

Reischies, Frederike; Hoenigl, Martin

doi:10.1111/myc.12224

Cited by 25 publications

(19 citation statements)

References 127 publications

(284 reference statements)

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“…Invasive aspergillosis (IA) is associated with high mortality rates [1–5]. Early and reliable diagnosis and rapid initiation of appropriate antifungal therapy has been shown to improve survival significantly [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Lateral Flow Assays for the Diagnosis of Invasive Aspergillosis: Current Status

Heldt

Hoenigl

2017

Curr Fungal Infect Rep

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Purpose of ReviewDiagnosis during early stages of invasive aspergillosis (IA) and targeted antifungal treatment has the potential to improve survival significantly. Despite advances in the diagnostic arsenal, invasive mold infections remain difficult to diagnose—especially at early stages before typical radiological signs develop. Varying availability and time-to-results are important limitations of current approved biomarkers and molecular assays for diagnosis of IA. Here, we will give an update on the Aspergillus-specific lateral-flow device (LFD) test. We further review promising findings on feasibility of point-of-care (POC) detection of urinary excreted fungal galactomannan-like antigens.Recent FindingsPOC LFD assays for detection of Aspergillus antigens are currently in development. The Aspergillus-specific LFD test, which is based on the JF5 antibody (Ab), detects an extracellular glycoprotein antigen secreted during active growth of Aspergillus spp. The test has shown promising results in various studies. In addition, a monoclonal Ab476-based LFD for POC detection of urinary excreted fungal galactomannan-like antigens has been developed but needs further validation.SummaryImportant advances have been made in the development of LFD assays for IA. Most promising is the Aspergillus-specific LFD test; commercial availability is still pending, however. The search for reliable POC tests for other molds, including mucorales, continues.

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Section: Introductionmentioning

confidence: 99%

Lateral Flow Assays for the Diagnosis of Invasive Aspergillosis: Current Status

Heldt

Hoenigl

2017

Curr Fungal Infect Rep

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“…[10,11,9] In most cases, diagnosed as FE, clinical presentations are large vegetations seen in echocardiography and the absence of positive blood cultures for typical bacterial agents. [5] In our case, an evident mass in right atrium, originating from right side of atrial septum and extanding to right ventricular cavity through tricuspit valve was detected in transthoracic echocardiography. Because of the right atrial origin and Figure 3 existance in atrial cavity, the mass looked like an atrial myxoma.…”

Section: Discussionmentioning

confidence: 94%

“…[5] We suggested that the mass in atrial cavity seen in echocardiography may reveal an infective mass because of the risk factors of exposure to wide spectrum antibiotics for a long time and our patient's being premature. But certain differential diagnosis was impossible only with echocardiographic findings, as blood culture tests were all negative.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical manifestations include, but not limited, central nervous system, catheter ascociated, eye, cutaneus, pulmonary, renal, gastrointestinal aspergillosis and osteomyelitis, endocarditis, pericarditis, arthtritis caused by Aspergillus species. [5] Infective endocarditis 98 Case Report (IE) is a serious but relatively rare infection that is associated with a high morbidity and mortality rates and predominated by causal agents that are bacterial in origin. Fungal endocarditis (FE) is reported less frequently than bacterial endocarditis in both adults and children, with an incidence in children of between 0 and 12% of total pediatric IEs.…”

Section: Discussionmentioning

confidence: 99%

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Right atrial aspergilloma mimicking atrial mixomax

Kolbakir¹,

Balaban²,

Baysal³

2016

ejcm

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Infective endocarditis is a serious but relatively rare infection that is associated with high morbidity and mortality rates. Aspergillus endocarditis is an uncommon entity and invasive cardiac aspergillosis is a severe and extremely life threatening disease. Prolonged use of intravascular catheters, anatomical cardiac conditions, exposure to multiple broad-spectrum antibiotics, intravenous drug abuse, and previous history of surgery are the most common risk factors of fungemia and fungal endocarditis. Diagnosis is based on the isolation of etiologic agents from cardiac and blood samples or specimens from other sterile sites or positive histopathological findings of pathologic specimens. Echocardiographic findings of endocardial involvement can lead to diagnosis. Echocardiographically, differencial diagnosis of tumor extensions, especially myxoma, atipically located bacterial vegetations, thrombus or fungal masses is very difficult as thrombi and infective verrus can mimic myxomas. Treatment of fungal endocarditis only with antifungal agents is generally unsuccessful and additional surgical intervention is usually required. In this case report we present an fungal endocarditis caused by Aspergillus species that mimicked an atrial myxoma echocardiographically in a patient who had a history of treatment with wide spectrum antibiotics for a long time. We suggest that patients who had broad spectrum antibiotic treatment for a long time should be scanned for fungal infections and if intracardiac mass is determined, fungal endocarditis should be considered in differential diagnosis. Keywords:

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“…Others have observed that surgical treatment alone in the absence of immunocompetency is often ineffective in the treatment of cutaneous aspergillosis. [ 94 ] Analogous to tumor resection, it is possible that surgery without systemic antifungal use may allow the survival of trace amounts of pathogen located at the wound margins or already spread distal to the wound through the vasculature or lymphatics. Surgical resection of large lesions was often associated with significant scarring and disfiguration.…”

Section: Discussionmentioning

confidence: 99%