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Infectious Disease Clinics of North... Jun 2021The spectrum of disease produced by Aspergillus species ranges from allergic syndromes to chronic pulmonary conditions and invasive infections. Invasive aspergillosis is... (Review)
Review
The spectrum of disease produced by Aspergillus species ranges from allergic syndromes to chronic pulmonary conditions and invasive infections. Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised patients. Risk factors continue to evolve and include newer biological agents that target the immune system and postinfluenza infection; and it has been observed following COVID-19 infection. Diagnosis remains a challenge but non-culture-based methods are available. Antifungal resistance has emerged. Voriconazole remains the treatment of choice but isavuconazole and posaconazole have similar efficacy with less toxicity. Combination therapy is used with extensive infection and in severe immunosuppression.
Topics: Antifungal Agents; Aspergillosis; Aspergillus; COVID-19; Disease Susceptibility; Drug Resistance, Fungal; Humans; Immunocompromised Host; Invasive Pulmonary Aspergillosis; Risk Factors
PubMed: 34016284
DOI: 10.1016/j.idc.2021.03.008 -
Clinical Microbiology Reviews Dec 2019is a saprotrophic fungus; its primary habitat is the soil. In its ecological niche, the fungus has learned how to adapt and proliferate in hostile environments. This... (Review)
Review
is a saprotrophic fungus; its primary habitat is the soil. In its ecological niche, the fungus has learned how to adapt and proliferate in hostile environments. This capacity has helped the fungus to resist and survive against human host defenses and, further, to be responsible for one of the most devastating lung infections in terms of morbidity and mortality. In this review, we will provide (i) a description of the biological cycle of ; (ii) a historical perspective of the spectrum of aspergillus disease and the current epidemiological status of these infections; (iii) an analysis of the modes of immune response against in immunocompetent and immunocompromised patients; (iv) an understanding of the pathways responsible for fungal virulence and their host molecular targets, with a specific focus on the cell wall; (v) the current status of the diagnosis of different clinical syndromes; and (vi) an overview of the available antifungal armamentarium and the therapeutic strategies in the clinical context. In addition, the emergence of new concepts, such as nutritional immunity and the integration and rewiring of multiple fungal metabolic activities occurring during lung invasion, has helped us to redefine the opportunistic pathogenesis of .
Topics: Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Disease Susceptibility; History, 21st Century; Host-Pathogen Interactions; Humans; Immunity; Immunocompromised Host; Public Health Surveillance; Treatment Outcome; Virulence
PubMed: 31722890
DOI: 10.1128/CMR.00140-18 -
Clinical Infectious Diseases : An... Aug 2016It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with...
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Azoles; Echinocandins; Humans; Infectious Disease Medicine; Societies, Medical; United States
PubMed: 27365388
DOI: 10.1093/cid/ciw326 -
Infectious Disease Clinics of North... Mar 2016Aspergillosis remains a significant cause of morbidity and mortality in the immunocompromised population. The spectrum of disease is broad, ranging from severe and... (Review)
Review
Aspergillosis remains a significant cause of morbidity and mortality in the immunocompromised population. The spectrum of disease is broad, ranging from severe and rapidly fatal infection to noninvasive disease. The diversity of patients and risk factors complicates diagnostic and therapeutic decision-making. Invasive procedures are often precluded by host status; noninvasive diagnostic tests vary in their sensitivity and specificity. Advancements in understanding the pathophysiology of invasive aspergillosis and host genetics in differential risk have also occurred. Future work may assist in therapeutic decision-making and patient prognosis. Voriconazole remains the preferred agent for treatment. Additional alternatives have emerged.
Topics: Antifungal Agents; Aspergillosis; Humans; Immunocompromised Host; Risk Factors
PubMed: 26897064
DOI: 10.1016/j.idc.2015.10.015 -
Clinical Microbiology Reviews Apr 1999Aspergillus fumigatus is one of the most ubiquitous of the airborne saprophytic fungi. Humans and animals constantly inhale numerous conidia of this fungus. The conidia... (Review)
Review
Aspergillus fumigatus is one of the most ubiquitous of the airborne saprophytic fungi. Humans and animals constantly inhale numerous conidia of this fungus. The conidia are normally eliminated in the immunocompetent host by innate immune mechanisms, and aspergilloma and allergic bronchopulmonary aspergillosis, uncommon clinical syndromes, are the only infections observed in such hosts. Thus, A. fumigatus was considered for years to be a weak pathogen. With increases in the number of immunosuppressed patients, however, there has been a dramatic increase in severe and usually fatal invasive aspergillosis, now the most common mold infection worldwide. In this review, the focus is on the biology of A. fumigatus and the diseases it causes. Included are discussions of (i) genomic and molecular characterization of the organism, (ii) clinical and laboratory methods available for the diagnosis of aspergillosis in immunocompetent and immunocompromised hosts, (iii) identification of host and fungal factors that play a role in the establishment of the fungus in vivo, and (iv) problems associated with antifungal therapy.
Topics: Animals; Antigens, Fungal; Aspergillosis; Aspergillus fumigatus; Disease Models, Animal; Humans; Serologic Tests; Virulence
PubMed: 10194462
DOI: 10.1128/CMR.12.2.310 -
The Veterinary Clinics of North... Jan 2014Feline aspergillosis includes sinonasal aspergillosis (SNA), sino-orbital aspergillosis (SOA), other focal invasive forms, and disseminated disease. SOA is an invasive... (Review)
Review
Feline aspergillosis includes sinonasal aspergillosis (SNA), sino-orbital aspergillosis (SOA), other focal invasive forms, and disseminated disease. SOA is an invasive mycosis that is being increasingly recognized, and is most commonly caused by a recently discovered pathogen Aspergillus felis. SNA can be invasive or noninvasive and is most commonly caused by Aspergillus 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; Cat Diseases; Cats; Immunocompromised Host
PubMed: 24268333
DOI: 10.1016/j.cvsm.2013.08.001 -
Avian Pathology : Journal of the W.V.P.A Apr 2020Aspergillosis is a disease of domestic and free-living birds caused by infection with a fraction of fungi within the genus . Species can be identified by colony... (Review)
Review
Aspergillosis is a disease of domestic and free-living birds caused by infection with a fraction of fungi within the genus . Species can be identified by colony morphology and microscopic characterization of conidia and conidiophores or by PCR, and isolates can be typed by microsatellite typing. Serodiagnostic options for testing are limited to antibody and antigen detection methods. The sensitivity of these tests can be enhanced through the use of protein electrophoresis. In many countries, no systemic antifungal drugs are registered for use in food-producing birds and resistance to antifungal drugs has been reported in strains derived from birds. The most important prevention strategy against aspergillosis is keeping the infection pressure low by adequate ventilation as well as cleaning and disinfection. Open questions about avian aspergillosis that research needs to address are related to epidemiology and serodiagnosis, as well as therapy and prevention.
Topics: Animal Husbandry; Animals; Aspergillosis; Bird Diseases; Birds
PubMed: 31766868
DOI: 10.1080/03079457.2019.1696946 -
European Journal of Clinical... May 1989Aspergillus spores are ubiquitous in the environment and may become concentrated in hospital ventilation systems. Colonization in normal hosts can lead to allergic... (Review)
Review
Aspergillus spores are ubiquitous in the environment and may become concentrated in hospital ventilation systems. Colonization in normal hosts can lead to allergic diseases ranging from asthma to allergic bronchopulmonary aspergillosis. Normal hosts rarely develop invasive disease, which is primarily an infection of severely immunocompromised patients. The major predisposing factors for infection include prolonged neutropenia, chronic administration of adrenal corticosteroids, the insertion of prosthetic devices, and tissue damage due to prior infection or trauma. Since Aspergillus spp. are respiratory pathogens, the most common form of infection is pneumonia followed by sinusitis. Patients with preexistant cavitary disease may develop noninvasive aspergillomas. Most infections are caused by Aspergillus fumigatus. The organism is capable of invading across all natural barriers, including cartilage and bone. It has a propensity for invading blood vessels causing thrombosis and infarction. The diagnosis of pulmonary infection is usually difficult to establish because the organism is seldom cultured from sputum and can represent contamination in some cases. Therapy is immunocompromised hosts is less than satisfactory and amphotericin B is the only agent with significant activity. There is anecdotal evidence to suggest that the addition of 5-fluorocytosine to amphotericin B may be beneficial.
Topics: Aspergillosis; Aspergillosis, Allergic Bronchopulmonary; Aspergillus; Bone Marrow Transplantation; Cross Infection; Humans; Immune Tolerance; Lung Diseases, Fungal; Neoplasms; Opportunistic Infections
PubMed: 2502407
DOI: 10.1007/BF01964057 -
Archives of Iranian Medicine Aug 2019
Topics: Aspergillosis; Brain Diseases; Child; Fatal Outcome; Humans; Immunocompromised Host; Liver Transplantation; Magnetic Resonance Imaging; Male
PubMed: 31679351
DOI: No ID Found -
Clinical Infectious Diseases : An... Apr 1998