The clinical value of Aspergillus-specific IgG antibody test in the diagnosis of nonneutropenic invasive pulmonary aspergillosis
Yajie LuLulu LiuHongxing LiBilin ChenYu GuLi WangChunlai FengCheng ChenYanbin ChenWenkui SunXuefan CuiMin CaoYujian TaoJinjin ZhongHuanhuan ZhongYueyan NiY. CaiMengyue SongXiaoguang LiuYi ShiXin Su
9
Citation
22
Reference
10
Related Paper
Citation Trend
Keywords:
Pulmonary aspergillosis
Cite
Citations (2)
With the increase in the number of patients receiving immunosuppressive therapy, the incidence of fungal infection is also on the rise. The fungus Aspergillus, a ubiquitous saprophyte, can produce pulmonary as well as systemic infection in several different forms. These include aspergilloma, primary pulmonary aspergillosis, allergic bronchopulmonary aspergillosis, invasive aspergillosis, and disseminated aspergillosis. The manifestations and treatment of these forms of infections vary greatly from one to another. In part II, the authors review and discuss primary pulmonary aspergillosis, allergic bronchopulmonary aspergillosis, and related conditions.
Allergic bronchopulmonary aspergillosis
Pulmonary aspergillosis
Cite
Citations (3)
A 78-year-old female diagnosed with myelodysplastic syndrome with excess blasts type 2 (MDS-EB2) 10 months ago was admitted to our hospital due to fever and a tender, 3-cm purple–red infiltrative erythema on her right lower leg. This single lesion evolved into multiple lesions with a sporotrichoid pattern over 4 days (Figure 1a). Laboratory data revealed a white blood cell count of 0.4 × 109/l]. A computed tomography scan revealed a halo sign in the upper lobe of her right lung (Figure 1b). Biopsies of the lung and lower leg were performed, and the histological examination showed mycelium of Aspergillus species (Figure 1c). These cultures grew Aspergillus fumigatus. The patient was prescribed liposomal amphotericin B for 2 months, and her clinical symptoms gradually improved (Figure 1d). Secondary cutaneous lesions result from contiguous extension to the skin of infected underlying structures or widespread blood-borne embolism of the skin (Bernardeschi et al., 2015Bernardeschi C. Foulet F. Ingen-Housz-Oro S. Ortonne N. Sitbon K. Quereux G. et al.Cutaneous invasive aspergillosis: retrospective multicenter study of the french invasive- aspergillosis registry and literature review.Medicine (Baltimore). 2015; 94: e1018Crossref PubMed Scopus (48) Google Scholar). The highly angiotropic nature of the Aspergillus species accounts for the usual lesion morphology in secondary dissemination to the skin (Watsky et al., 1990Watsky K.L. Eisen R.N. Bolognia J.L. Unilateral cutanenous emboli of Aspergillius.Arch Dermatol. 1990; 126: 1214-1217Crossref PubMed Scopus (29) Google Scholar). The cutaneous infection described in this case was disseminated disease from the pulmonary site, because the skin of the patient's lower leg was undamaged, and the purple–red infiltrative erythema occurred on normal skin. A biopsy should be performed to obtain an accurate diagnosis because secondary cutaneous aspergillosis can resemble ecthyma gangrenosum and Sweet's syndrome (van der Werf et al., 2003van der Werf T.S. Stienstra Y. van der Graaf W.T. Skin ulcers misdiagnosed as pyoderma gangrenosum.N Engl J Med. 2003; 348: 1064-1066Crossref PubMed Scopus (6) Google Scholar). No funding received for this report.
Pulmonary aspergillosis
Cite
Citations (1)
The incidence of infection with Aspergillus has increased in recent years. A. fumigatus of genus Aspergillus is responsible for more than 90% of invasive disease while flavus, terreus, and niger are responsible for the majority of remaining invasive aspergillosis cases. Metabolites (toxins and enzymes) make this eukaryotic group successful for the survival in a host thereby interacting and overcoming the host immune system. A total of 80 filamentous fungi (Aspergillus flavus (20 isolates), A. fumigatus (15), A. niger (30) and A. terreus (15) isolated from suspected patients (suffering from severe persisting asthma, COPD and unresolved pneumonia) with aspergillosis disease at Assiut university hospitals were screened for their ability to produce extracellular enzymes in solid media and their ability to produce toxins. The results revealed that 66, 66, 68 and 72 isolates produced protease, lipase, urease, phospholipase, respectively. Also, all of the tested isolates have the ability to produce catalase, peroxidase and can utilize the lung tissue; meanwhile, 70 of the tested isolates exhibited hemolytic activities. One at least of toxins (aflatoxins B1, B2, gliotoxin, fumagillin, ochratoxin and territrem) was produced by the tested isolates on Thin-layer chromatography and these results were confirmed by High-performance liquid chromatography. These results demonstrated that the fungi isolated as a causal agent of aspergillosis disease possess the most important pathogenic tools (extracellular enzymes and toxins) and can9t be underestimated, so, fast diagnosis for the fungus with an effective treatment is a life-saving step.
Cite
Citations (0)
Cite
Citations (0)
Invasive aspergillosis is a common infection in patients who are immunocompromised. The diagnosis of invasive aspergillosis is difficult in the absence of confirmation by tissue biopsy and histological studies. Therefore, recent advances that may be important for the development of highly sensitive and specific serodiagnostic tests for the early diagnosis of invasive aspergillosis are reviewed. The inability of the detection of antibody to Aspergillus to lead to early diagnosis of invasive aspergillosis also is emphasized. However, sensitive methods that reliably detect significant amounts of aspergillus antigen in body fluids of high-risk patients are currently being evaluated and may provide a noninvasive early diagnostic test that is both sensitive and specific. Also, current antifungal agents with anti-aspergillus activity that have potential as therapeutic or prophylactic agents are reviewed briefly.
Cite
Citations (114)
We report a case of two consecutive episodes of invasive aspergillosis caused by cryptic Aspergillus species in a patient with leukaemia. A first episode of pulmonary infection was caused by Aspergillus calidoustus and Aspergillus novofumigatus, and the second episode by A. novofumigatus and Aspergillus viridinutans. Fungal isolates were identified to species level using traditional and sequencing-based molecular methods.
Species complex
Pulmonary aspergillosis
Cite
Citations (46)
Keywords: Aspergillus fumigatus, Aspergillosis, Pulmonary Aspergillosis, Allergic pulmonary aspergillosis, Aspergilloma, Cutaneous aspergillosis
Aspergilloma
Pulmonary aspergillosis
Allergic bronchopulmonary aspergillosis
Cite
Citations (70)
Pulmonary aspergillosis
Cite
Citations (1)
Aspergillus is a ubiquitous mould genus typically found in soil and rotting vegetation. Sources, modes and treatment. In defining the diseases caused by Aspergillus, the term' aspergillosis 'is used but most generally refers to those caused by Aspergillus fumigatus. Aspergillus flavus, Aspergillus terreus and Aspergillus niger are other animals that can cause human illness [1]. Aspergillus releases massive numbers of conidia (asexual spores) into the air as part of its life cycle and can thus be present in both outdoor and indoor environments. Aspergillus conidia inhalation is normally a daily phenomenon, but only a limited number of individuals experience chronic illness and are at an elevated risk of aspergillosis (e.g. people with compromised immune systems and/or impaired lungs). It is difficult to quantify the burden of aspergillosis in the UK because of the insensitivity of fungal culture, the lack of regular, sensitive, non-culture diagnostic testing and the lack of a national surveillance network. A 2017 study estimated that 3,288-4,257 cases of invasive aspergillosis, up to 3,600 cases of recurrent pulmonary aspergillosis and 110,667-235,070 cases of allergic bronchopulmonary aspergillosis (ABPA) complicating asthma or cystic fibrosis are registered every year in the UK [2].
Allergic bronchopulmonary aspergillosis
Aspergillus terreus
Cite
Citations (0)