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Clinics in Chest Medicine Sep 2017Aspergillus spp are ubiquitous in the environment, and inhalation of Aspergillus spores is unavoidable. An intact immune system, with normal airway function, protects... (Review)
Review
Aspergillus spp are ubiquitous in the environment, and inhalation of Aspergillus spores is unavoidable. An intact immune system, with normal airway function, protects most people from disease. Globally, however, the toll from aspergillosis is high. The literature has largely focused on invasive aspergillosis, yet the burden in terms of chronicity and prevalence is higher for noninvasive Aspergillus conditions. This article discusses allergic aspergilloses and provides an update on the diagnosis and management of allergic bronchopulmonary aspergillosis, including in patients with cystic fibrosis, and an update on severe asthma with fungal sensitization. In addition, the presentation, investigation, and management of noninvasive infectious aspergilloses are reviewed.
Topics: Aspergillosis, Allergic Bronchopulmonary; Aspergillus; Humans; Lung; Syndrome
PubMed: 28797493
DOI: 10.1016/j.ccm.2017.04.012 -
European Journal of Radiology Feb 2024Pulmonary aspergillosis is a group of mycotic diseases affecting the lungs. The form of the disease mainly depends on the immune status of the patient and underlying... (Review)
Review
Pulmonary aspergillosis is a group of mycotic diseases affecting the lungs. The form of the disease mainly depends on the immune status of the patient and underlying conditions. Invasive pulmonary aspergillosis usually affects immunocompromised patients - angio-invasive and airway-invasive forms are possible. Chronic aspergillosis usually appears in mildly immunosuppressed or immunocompetent patients with underlying structural lung changes and may have diverse forms: simple aspergilloma, chronic cavitary pulmonary aspergillosis, chronic fibrosing pulmonary aspergillosis, subacute invasive pulmonary aspergillosis, aspergillus nodules and endobronchial aspergilloma. Allergic bronchopulmonary aspergillosis is a hyper-reactivity reaction to Aspergillus species, and usually develops in asthma and cystic fibrosis patients. The aim of this article is to comprehensively overview different forms of aspergillosis, their symptoms and underlying conditions and to present imaging findings.
Topics: Humans; Invasive Pulmonary Aspergillosis; Pulmonary Aspergillosis; Aspergillosis, Allergic Bronchopulmonary; Aspergillosis; Lung
PubMed: 38219353
DOI: 10.1016/j.ejrad.2024.111290 -
Expert Opinion on Pharmacotherapy 2015Triazole antifungals are frontline drugs for the treatment and prophylaxis of infections due to Aspergillus species. Azole resistance is an emerging problem and is...
Triazole antifungals are frontline drugs for the treatment and prophylaxis of infections due to Aspergillus species. Azole resistance is an emerging problem and is associated with treatment failure in several case series. The management of azole-resistant invasive aspergillosis remains a challenge and there are no guidelines with appropriate recommendations. The current clinical practice suggests that liposomal amphotericin B or a combination of voriconazole or posaconazole with an echinocandin may be effective. Although cross-resistance within the azoles seems to be common, the role of azoles in the management of azole-resistant aspergillosis remains unclear, but optimizing drug exposure is critical for treatment success.
Topics: Antifungal Agents; Aspergillosis; Aspergillus; Azoles; Drug Resistance, Fungal; Drug Therapy, Combination; Echinocandins; Humans
PubMed: 26328502
DOI: 10.1517/14656566.2015.1083976 -
Transplant International : Official... 2023Solid organ transplant (SOT) recipients have a higher risk of developing invasive mould diseases (IMD). Isavuconazole is a novel broad-spectrum azole active against... (Review)
Review
Solid organ transplant (SOT) recipients have a higher risk of developing invasive mould diseases (IMD). Isavuconazole is a novel broad-spectrum azole active against spp. and Mucor, well tolerated, with an excellent bioavailability and predictable pharmacokinetics, that penetrates in most tissues rapidly, and has few serious adverse effects, including hepatic toxicity. Contrary to other broad-spectrum azoles, such as voriconazole and posaconazole, isavuconazole appears to show significant smaller drug-drug interactions with anticalcineurin drugs. We have performed an extensive literature review of the experience with the use of isavuconazole in SOT, which included the SOTIS and the ISASOT studies, and published case reports. More than 140 SOT recipients treated with isavuconazole for IMD were included. Most patients were lung and kidney recipients treated for an infection. Isavuconazole was well tolerated (less than 10% of patients required treatment discontinuation). The clinical responses appeared comparable to that found in other high-risk patient populations. Drug-drug interactions with immunosuppressive agents were manageable after the reduction of tacrolimus and the adjustment of mTOR inhibitors at the beginning of treatment. In conclusion, isavuconazole appears to be a reasonable option for the treatment of IMD in SOT. More clinical studies are warranted.
Topics: Humans; Antifungal Agents; Aspergillosis; Nitriles; Organ Transplantation; Transplant Recipients; Voriconazole
PubMed: 38161768
DOI: 10.3389/ti.2023.11845 -
Health Estate Oct 2014Aspergillus, a fungus whose spores are ubiquitous in the environment, and are normally found in air, can be a significant issue in healthcare premises, and especially in... (Review)
Review
Aspergillus, a fungus whose spores are ubiquitous in the environment, and are normally found in air, can be a significant issue in healthcare premises, and especially in hospital ventilation systems. Here Andrew Poplett, an engineer with over 28 years' healthcare building services engineering experience, and an Authorised Engineer for both specialist ventilation and water quality, explains its occurrence, spread, and prevalence. He discusses how estates and facilities personnel, in conjunction with their clinical and infection control counterparts, can act to control and manage Aspergillus, and thus help safeguard patients, staff, and visitors, in hospitals and other healthcare facilities, against its negative impact on health.
Topics: Air Microbiology; Aspergillosis; Aspergillus fumigatus; Cross Infection; Disease Outbreaks; Humans; Infection Control; Maintenance and Engineering, Hospital; Ventilation; Water Microbiology
PubMed: 29512989
DOI: No ID Found -
The Veterinary Clinics of North... Mar 2020Fungal rhinosinusitis, including sinonasal aspergillosis (SNA) and sino-orbital aspergillosis (SOA), is the most common type of aspergillosis encountered in cats. Other... (Review)
Review
Fungal rhinosinusitis, including sinonasal aspergillosis (SNA) and sino-orbital aspergillosis (SOA), is the most common type of aspergillosis encountered in cats. Other focal forms of aspergillosis including disseminated invasive aspergillosis occur less frequently. SOA is an invasive mycosis that is increasingly recognized and is most commonly caused by Aspergillus felis, a close relative of Aspergillus fumigatus. SNA can be invasive or noninvasive and is most commonly caused by A fumigatus and Aspergillus niger. Molecular methods are required to correctly identify the fungi that cause SNA and SOA. SNA has a favorable prognosis with treatment, whereas the prognosis for SOA remains poor.
Topics: Animals; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Aspergillus niger; Cat Diseases; Cats; Diagnosis, Differential; Sinusitis
PubMed: 31866094
DOI: 10.1016/j.cvsm.2019.10.006 -
Future Microbiology 2016Invasive aspergillosis is a major cause of morbidity and mortality in immunosuppressed patients. Early diagnosis and correct antifungal treatment have a direct impact on... (Review)
Review
UNLABELLED
Invasive aspergillosis is a major cause of morbidity and mortality in immunosuppressed patients. Early diagnosis and correct antifungal treatment have a direct impact on patient survival. A number of newer diagnostic procedures have been developed as alternatives to conventional microbiological methods. The detection of fungal components, largely antigens and DNA, are used in clinical laboratories to diagnose invasive aspergillosis. Other rapid diagnostic tests have been recently developed with promising results. However, antifungal resistance is becoming an emerging problem. The detection of this resistance is important to administer the proper antifungal agent. This text reviews the novelties on new diagnostics Aspergillus spp.
PROCEDURES
Intrinsic antifungal resistance and mechanisms of secondary resistance to triazoles in A. fumigatus are also reviewed.
Topics: Antifungal Agents; Aspergillosis; Aspergillus; Biomarkers; Drug Resistance, Fungal; Humans; Microbial Sensitivity Tests; Microbiological Techniques
PubMed: 26848512
DOI: 10.2217/fmb.15.140 -
Medical Mycology Journal 2022Aspergillosis is a major fungal infection in humans and animals. Penguins (Order Spheniscidae) are particularly susceptible to aspergillosis, and aspergillosis in...
Aspergillosis is a major fungal infection in humans and animals. Penguins (Order Spheniscidae) are particularly susceptible to aspergillosis, and aspergillosis in captive penguins is presently a major problem. We were faced with the challenge of combating aspergillosis in an aquarium. As a solution, we organized a multidisciplinary aspergillosis control team, including a medical and veterinary mycologist. Since Aspergillus, including Aspergillus fumigatus, is abundant in soil, we thought it necessary to minimize contact between captive penguins and soil to prevent aspergillosis. As a countermeasure, we stopped using a route for outdoor penguin marches where the soil was exposed. Additionally, after outdoor penguin marches, the feet of penguins were washed with seawater to avoid bringing soil into the rearing facility for penguins. Furthermore, since A. fumigatus was detected on several spots in the environment of the rearing facility by swab analysis, we cleaned and sanitized the rearing facility with 0.02% sodium hypochlorite and hot water. As a result of the above measures, there has been no incidence of aspergillosis in captive penguins since 2016. These results show that our preventive measures are working well. As shown here, we presented an example of how the multidisciplinary control team, which included a mycologist, successfully implemented preventive measures against aspergillosis. Due to changes in the rearing environment and the impact of global warming on penguins, it is expected that the role of mycologists in aspergillosis control will expand in the future.
Topics: Animals; Aspergillosis; Aspergillus; Aspergillus fumigatus; Soil; Spheniscidae
PubMed: 35650070
DOI: 10.3314/mmj.22.002 -
Revista Iberoamericana de Micologia 2021
Topics: Agriculture; Animals; Antifungal Agents; Aspergillosis; Drug Resistance, Fungal; Poultry
PubMed: 32505522
DOI: 10.1016/j.riam.2020.03.004 -
Advances in Experimental Medicine and... 2016The biofilm phenotype of Aspergillus species is an important and accepted clinical entity. While industrially these biofilms have been used extensively in important... (Review)
Review
The biofilm phenotype of Aspergillus species is an important and accepted clinical entity. While industrially these biofilms have been used extensively in important biofermentations, their role in clinical infection is less well defined. A recent flurry of activity has demonstrated that these interesting filamentous moulds have the capacity to form biofilms both in vitro and in vivo, and through various investigations have shown that these are exquisitely resistant to antifungal therapies through a range of adaptive resistance mechanisms independent of defined genetic changes. This review will explore the clinical importance of these biofilms and provide contemporary information with respect to their clinical management.
Topics: Antifungal Agents; Aspergillosis; Aspergillus; Biofilms; Humans
PubMed: 27271678
DOI: 10.1007/5584_2016_4