[Acute invasive pulmonary aspergillosis in chronic lung disease--a review]

Details

Serval ID
serval:BIB_6CEE97B5091F
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
[Acute invasive pulmonary aspergillosis in chronic lung disease--a review]
Journal
Rev Mal Respir
Author(s)
Ader F., Nseir S., Guery B., Tillie-Leblond I.
ISSN
0761-8425 (Print)
ISSN-L
0761-8425
Publication state
Published
Issued date
06/2006
Volume
23
Number
3 Suppl
Pages
6S11-6S20
Language
french
Notes
Ader, F
Nseir, S
Guery, B
Tillie-Leblond, I
fre
English Abstract
Review
France
Rev Mal Respir. 2006 Jun;23(3 Suppl):6S11-6S20.
Abstract
INTRODUCTION: Apart from malignancies and solid organ transplant, chronic lung disease, in particular chronic obstructive pulmonary disease (COPD), is a third important predisposing factor for acute invasive pulmonary aspergillosis. STATE OF THE ART: COPD is present in 2% of patients dying from invasive aspergillosis. This opportunistic infection occurs because of an immunodeficiency linked both to altered local immunity and to systemic factors such as long term steroid treatment and malnutrition. In patients whose sputum and/or endotracheal aspirate specimens contain hyphal forms of filamentous Aspergillus, half will have a clinically significant aspergillus infection. Diagnostic tests include serum galactomannan antigen test, serum antibody titre, thoracic CT scan and bronchoalveolar lavage (BAL). The identification of fungal hyphae in BAL fluid by microscopy and/or on culture is critical for a positive diagnosis. The mortality rate for acute invasive pulmonary aspergillosis in chronic lung diseases reaches almost 100%. Antifungal monotherapy is still recommended as a first line treatment. Combined treatment can be used in refractory aspergillosis as a salvage therapy. The question of maintaining, decreasing or interrupting steroid treatment must be considered. PERSPECTIVES: Prospective studies are needed to evaluate a standardised diagnostic strategy such as exists for patients with haematological disease. Whether this will improve prognosis remains to be seen. CONCLUSION: Acute invasive pulmonary aspergillosis complicating chronic lung disease is not rare. Improved diagnosis procedures and recent therapeutic advances may have a positive impact on patient prognosis.
Keywords
Antifungal Agents/therapeutic use, Aspergillosis/diagnosis/*etiology, Cause of Death, Humans, Immunocompromised Host, Lung Diseases, Fungal/diagnosis/*etiology, Opportunistic Infections/etiology, Prognosis, Pulmonary Disease, Chronic Obstructive/*complications, Risk Factors
Pubmed
Create date
29/04/2021 10:59
Last modification date
30/04/2021 6:38
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