ABSTRACT
Invasive pulmonary aspergillosis (IPA) is a severe disease, specially among immunocompromised patients. Its frequency increases in other patients such as those with Chronic Obstructive Pulmonary Disease (COPD), mainly when steroids are prescribed. The most common form of presentation is a respiratory tract infection with poor response to antimicrobial treatment. The delay in its diagnosis is one of the main causes of its high lethality. Once suspected, respiratory secretion cultures, chest X ray examination and computed tomography should be obtained and galactomannan, a marker of hematogenous dissemination of the microorganism, should be determined. Although the repeated isolation of Aspergillus spp is suggestive of invasive disease, the definitive diagnosis requires cytopathological confirmation. Further studies should be performed in these patients, since the available information was obtained from the observations made in immunocompromised patients, and may not be applicable accurately to API among COPD patients.
Subject(s)
Humans , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Pulmonary Disease, Chronic Obstructive/diagnosis , Aspergillosis, Allergic Bronchopulmonary/immunology , Aspergillosis, Allergic Bronchopulmonary/physiopathology , Pulmonary Disease, Chronic Obstructive/microbiologySubject(s)
Humans , Aspergillosis/immunology , Aspergillosis, Allergic Bronchopulmonary/immunology , Aspergillosis/classification , Aspergillosis/diagnosis , Aspergillus , Aspergillus fumigatus , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Aspergillosis, Allergic Bronchopulmonary/physiopathologyABSTRACT
La aspergilosis es una infección oportunista, potencialmente letal. Se describen sus distintas formas de presentación con su correlación clínico-radiológica y anatomopatológica. Se examinaron retrospectivamente 5.580 tomografías de tórax (1987-1995) de pacientes internados con diagnóstico de aspergilosis, encontrándose 15 pacientes con aspergilosis confirmada. El compromiso pulmonar con Aspergillus fumigatus es variado y ampliamente dependiente del estado inmunológico del paciente y de su grado de respuesta a la infección, así como también del estado pulmonar preexistente. La TC es un excelente método para el temprano reconocimiento y pronta institución terapéutica en el paciente inmunocomprometido, así como en el control de su evolución
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aspergillosis/diagnosis , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Tomography, X-Ray Computed , Aspergillosis/classification , Aspergillus fumigatus/pathogenicity , Aspergillosis, Allergic Bronchopulmonary/physiopathology , Aspergillosis, Allergic Bronchopulmonary , Asthma/complications , Bronchiectasis , Bronchiectasis/etiology , Diagnostic Imaging , Retrospective StudiesABSTRACT
La aspergilosis broncopulmonar alérgica (ABPA) es una enfermedad cuyos hallazgos clínicos, inmunológicos, radiológicos y patológicos semejan al asma. Los criterios diagnósticos, estadios y datos clínicos, patológicos y radiológicos que establecen el diagnóstico se describen. Un diagnóstico y tratamiento tempranos, prevendrán la ocurrencia de casos terminales