Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
Add more filters










Database
Publication year range
1.
Med Mycol ; 54(6): 576-83, 2016 Aug 01.
Article in English | MEDLINE | ID: mdl-26941254

ABSTRACT

UNLABELLED: Aspergillus spp.-related morbidity and mortality remains a major challenge in the management of neutropenic patients. Little is known about the impact of domestic Aspergillus spp. EXPOSURE: In this controlled prospective study, fungal spores were collected from homes of neutropenic patients. Cases were defined as patients with probable or proven controls as patients with no invasive pulmonary aspergillosis, while patients with possible disease were evaluated as a third group. Forty patients were enrolled and returned questionnaires on high-risk activities and mould exposure. A. fumigatus was detected in concentrations of 0 to 76 cfu/m(3) in every home. A. terreus was detected in nine (18%) homes. Mean Aspergillus spp. cfu/m(3) according to EORTC criteria were: proven/probable IA (15 patients) - 36; possible IA (12 patients) - 42; no IA (13 patients) - 42. Of the seven patients with self-reported moulded walls at home, four had probable and three had possible aspergillosis; the risk ratio of developing IA was 1.65 (95% CI: 1.25-2.17). In conclusion self-reported domestic mould exposure was associated with a high incidence of IA and may be a feasible tool for identifying high-risk patients. There was no correlation between domestic ambient-air spore counts and IA.


Subject(s)
Air Microbiology , Aspergillus/isolation & purification , Environmental Exposure , Hematologic Diseases/complications , Invasive Pulmonary Aspergillosis/epidemiology , Invasive Pulmonary Aspergillosis/etiology , Spores, Fungal/isolation & purification , Adult , Aged , Case-Control Studies , Colony Count, Microbial , Female , Humans , Incidence , Male , Middle Aged , Pilot Projects , Prospective Studies , Surveys and Questionnaires , Young Adult
2.
Dtsch Med Wochenschr ; 139(44): 2242-7, 2014 Oct.
Article in German | MEDLINE | ID: mdl-25084311

ABSTRACT

Chronic pulmonary aspergillosis (CPA) is a rare complication in patients with either mild immunosuppression or various pulmonary diseases. Diagnosis and therapy are challenging because of unspecific symptoms like productive cough, weight loss, fever and haemoptysis. Differential diagnoses are manifold, and CPA is characterized by findings in chest CT and serologic proof of precipitins. Surgery is only recommended for simple aspergillomas. Recurrent prolonged courses of antifungal treatment yield satisfactory short-term outcome, but long-term prognosis is uncertain. We provide an overview of the literature and present four cases to illustrate disease diversity.


Subject(s)
Opportunistic Infections/diagnosis , Pulmonary Aspergillosis/diagnosis , Aged , Antifungal Agents/administration & dosage , Chronic Disease , Diagnosis, Differential , Fatal Outcome , Female , Humans , Long-Term Care , Lung/pathology , Lung/surgery , Male , Middle Aged , Opportunistic Infections/pathology , Opportunistic Infections/therapy , Prognosis , Pulmonary Aspergillosis/pathology , Pulmonary Aspergillosis/therapy , Recurrence , Tomography, X-Ray Computed
3.
Mycoses ; 57(5): 257-70, 2014 May.
Article in English | MEDLINE | ID: mdl-24299422

ABSTRACT

Chronic pulmonary aspergillosis (CPA) is a group of consuming diseases usually presenting with prolonged and relapsing cough, dyspnoea and weight loss. Acute symptoms such as haemoptysis and bronchial or pulmonary haemorrhage may occasionally occur. CPA affects patients with underlying pulmonary conditions, for example, chronic obstructive pulmonary disease or mycobacteriosis or common immunosuppressive conditions such as diabetes. Precise epidemiology is unknown, and while prevalence is considered low the chronic and relapsing nature of the disease challenges the treating physician. Diagnostics largely rely on serologic Aspergillus precipitins and findings on thoracic computed tomography. The latter are manifold comprising cavity formation, pleural involvement and sometimes aspergilloma. Other markers for aspergillosis are less helpful, in part due to the non- or semi-invasive nature of these forms of Aspergillus infection. Various antifungals were shown to be effective in CPA treatment. Azoles are the most frequently applied antifungals in the outpatient setting, but are now compromised by findings of Aspergillus resistance. Long-term prognosis is not fully elucidated and may be driven by the underlying morbidities. Prospective registry-type studies may be suitable to systematically broaden our CPA knowledge base. This article gives an overview of the available literature and proposes a clinical working algorithm for CPA management.


Subject(s)
Aspergillus/physiology , Pulmonary Aspergillosis/drug therapy , Animals , Antifungal Agents/therapeutic use , Aspergillus/genetics , Aspergillus/isolation & purification , Humans , Pulmonary Aspergillosis/diagnosis , Pulmonary Aspergillosis/microbiology
SELECTION OF CITATIONS
SEARCH DETAIL
...