open access

Vol 87, No 6 (2019)
REVIEWS
Published online: 2020-01-14
Submitted: 2019-10-10
Accepted: 2019-12-04
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Advances in the diagnosis and management of pulmonary aspergillosis

Yuqing Gao, Ayman Soubani
DOI: 10.5603/ARM.2019.0061
·
Pubmed: 31970725
·
Adv Respir Med 2019;87(6):231-243.

open access

Vol 87, No 6 (2019)
REVIEWS
Published online: 2020-01-14
Submitted: 2019-10-10
Accepted: 2019-12-04

Abstract

Aspergillus is a mould that is ubiquitous in nature and may lead to a variety of infectious and allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients appear to be at an increased risk as well. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic pulmonary aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Recently, the European Society for Clinical Microbiology and Infectious Diseases provided a more robust sub-classification of this entity that allows for a straightforward approach to diagnosis and management. Allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. It also details the role of noninvasive tests in the diagnosis of Aspergillus related lung diseases and advances in the management of these disorders.

Abstract

Aspergillus is a mould that is ubiquitous in nature and may lead to a variety of infectious and allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients appear to be at an increased risk as well. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic pulmonary aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Recently, the European Society for Clinical Microbiology and Infectious Diseases provided a more robust sub-classification of this entity that allows for a straightforward approach to diagnosis and management. Allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. It also details the role of noninvasive tests in the diagnosis of Aspergillus related lung diseases and advances in the management of these disorders.

Get Citation

Keywords

aspergillus, invasive pulmonary aspergillosis, invasive pulmonary aspergillosis

About this article
Title

Advances in the diagnosis and management of pulmonary aspergillosis

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 6 (2019)

Pages

231-243

Published online

2020-01-14

DOI

10.5603/ARM.2019.0061

Pubmed

31970725

Bibliographic record

Adv Respir Med 2019;87(6):231-243.

Keywords

aspergillus
invasive pulmonary aspergillosis
invasive pulmonary aspergillosis

Authors

Yuqing Gao
Ayman Soubani

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