ABSTRACT
The base of current management of bronchopulmonary aspergillosis with allergic manifestations (BPAAM) is glucocorticosteroid treatment. These hormones are introduced in a mean dose 0.5 mg/kg (by prednisolone) to correct bronchial obstruction, reduce eosinophilia and resolve (completely or partially) infiltrates in the lungs. This being achieved, the dose is lowered to warrant maintenance. Minimal doses or discontinuation of glucocorticosteroids may be used in case of adjuvant indomethacin (0.025 three times a day) or plasmapheresis administration. In remission, fungistatic means with glucocorticosteroids or without them (in the absence of bronchial obstruction) are proper. Inhalations in BPAAM are ineffective. Individual schemes of the disease treatment may vary in wide range.
Subject(s)
Aspergillosis, Allergic Bronchopulmonary/drug therapy , Antifungal Agents/administration & dosage , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Aspergillosis, Allergic Bronchopulmonary/etiology , Drug Therapy, Combination , Expectorants/administration & dosage , Humans , Indomethacin/administration & dosage , Lung/diagnostic imaging , Prednisolone/administration & dosage , Radiography , Remission InductionABSTRACT
Five patients (4 men and 1 woman) afflicted with bronchopulmonary aspergillosis (ABPA) were examined. The main criteria for the diagnosis were a high level of the total IgE, demonstration of specific IgE to Aspergillus fumigatus, positive skin tests with antigens of moldy fungi. All the 4 patients with active process, not given corticosteroids, manifested eosinophilia of the sputum and peripheral blood. The clinical picture of bronchial asthma was recorded in 2 patients. It is desirable that all the patients with protracted and relapsing infiltrative processes in the lungs running with sputum and blood eosinophilia undergo examinations for the presence of ABPA.
Subject(s)
Aspergillosis, Allergic Bronchopulmonary/diagnosis , Antibody Specificity , Antigens, Fungal/immunology , Aspergillosis, Allergic Bronchopulmonary/microbiology , Aspergillus flavus/immunology , Aspergillus flavus/isolation & purification , Bronchoalveolar Lavage Fluid/microbiology , Diagnosis, Differential , Female , Humans , Immunoglobulin E/analysis , Male , Sputum/microbiologySubject(s)
Encephalitis/diagnosis , Mycoses/diagnosis , Adult , Encephalitis/surgery , Humans , Male , Mycoses/surgerySubject(s)
Asthma/complications , Candidiasis/diagnosis , Adult , Antifungal Agents/therapeutic use , Asthma/microbiology , Candida/isolation & purification , Candidiasis/drug therapy , Candidiasis/microbiology , Carrier State/diagnosis , Carrier State/drug therapy , Carrier State/microbiology , Female , Humans , Immunoglobulins/analysis , Lung Diseases, Fungal/diagnosis , Lung Diseases, Fungal/drug therapy , Lung Diseases, Fungal/microbiology , Male , Middle Aged , Sputum/microbiology , T-Lymphocytes/immunologyABSTRACT
The examination of 73 patients with superficial and visceral candidiasis and Candida-carriers yielded no data to the effect that the increased activity of opportunistic fungi of the genus Candida in the body was preceded by organic lesions in the T- and B-systems of lymphocytes. Only in 16 patients who had visceral candidiasis for 8-12 years with combined lesions of several organs the decreased capacity of lymphocytes for reacting with phytohemagglutinin was observed, which was probably a manifestation of the secondary immune insufficiency, developing in the presence of prolonged infection.
