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The clinical spectrum of pulmonary aspergillosis

The clinical presentation of lung disease is determined by the interaction between fungus and host. Invasive aspergillosis develops in severely immunocompromised patients, including those with neutropenia, and increasingly in the non-neutropenic host, including lung transplant recipients, the critic... Full description

Journal Title: Thorax 29 March 2015, Vol.70(3), p.270
Main Author: Kosmidis, Chris
Other Authors: Denning, David W
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: BMJ Publishing Group Ltd and British Thoracic Society
ID: ISSN: 0040-6376 ; E-ISSN: 1468-3296 ; DOI: 10.1136/thoraxjnl-2014-206291 ; PMID: 25354514
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recordid: bmj_journals10.1136/thoraxjnl-2014-206291
title: The clinical spectrum of pulmonary aspergillosis
format: Article
creator:
  • Kosmidis, Chris
  • Denning, David W
subjects:
  • Aspergillus Lung Disease
ispartof: Thorax, 29 March 2015, Vol.70(3), p.270
description: The clinical presentation of lung disease is determined by the interaction between fungus and host. Invasive aspergillosis develops in severely immunocompromised patients, including those with neutropenia, and increasingly in the non-neutropenic host, including lung transplant recipients, the critically ill patients and patients on steroids. A high index of suspicion is required in patients without the classical risk factors as early presentation is usually silent and non-specific, pyrexia uncommon and timely treatment is crucial for survival. Invasive aspergillosis has also been diagnosed in normal hosts after massive exposure to fungal spores. Chronic pulmonary aspergillosis affects patients without obvious immune compromise, but with an underlying lung condition such as COPD or sarcoidosis, prior or concurrent TB or non-tuberculous mycobacterial disease. bronchitis may be responsible for persistent respiratory symptoms in patients with detected repeatedly in sputum without evidence of parenchymal disease, especially in patients with bronchiectasis and cystic fibrosis. Allergic bronchopulmonary aspergillosis affects patients with asthma and cystic fibrosis, and is important to recognise as permanent lung or airways damage may accrue if untreated. Changes in the classification of allergic lung disease have been proposed recently. Cases of extrinsic allergic alveolitis and chronic pulmonary aspergillosis have been observed after exposure. Asymptomatic colonisation of the respiratory tract needs close monitoring as it can lead to clinical disease especially with ongoing immunosuppression. The various syndromes should be viewed as a semicontinuous spectrum of disease and one form may evolve into another depending on the degree of ongoing immunosuppression.
language: eng
source:
identifier: ISSN: 0040-6376 ; E-ISSN: 1468-3296 ; DOI: 10.1136/thoraxjnl-2014-206291 ; PMID: 25354514
fulltext: fulltext
issn:
  • 00406376
  • 14683296
  • 0040-6376
  • 1468-3296
url: Link


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descriptionThe clinical presentation of lung disease is determined by the interaction between fungus and host. Invasive aspergillosis develops in severely immunocompromised patients, including those with neutropenia, and increasingly in the non-neutropenic host, including lung transplant recipients, the critically ill patients and patients on steroids. A high index of suspicion is required in patients without the classical risk factors as early presentation is usually silent and non-specific, pyrexia uncommon and timely treatment is crucial for survival. Invasive aspergillosis has also been diagnosed in normal hosts after massive exposure to fungal spores. Chronic pulmonary aspergillosis affects patients without obvious immune compromise, but with an underlying lung condition such as COPD or sarcoidosis, prior or concurrent TB or non-tuberculous mycobacterial disease. bronchitis may be responsible for persistent respiratory symptoms in patients with detected repeatedly in sputum without evidence of parenchymal disease, especially in patients with bronchiectasis and cystic fibrosis. Allergic bronchopulmonary aspergillosis affects patients with asthma and cystic fibrosis, and is important to recognise as permanent lung or airways damage may accrue if untreated. Changes in the classification of allergic lung disease have been proposed recently. Cases of extrinsic allergic alveolitis and chronic pulmonary aspergillosis have been observed after exposure. Asymptomatic colonisation of the respiratory tract needs close monitoring as it can lead to clinical disease especially with ongoing immunosuppression. The various syndromes should be viewed as a semicontinuous spectrum of disease and one form may evolve into another depending on the degree of ongoing immunosuppression.
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abstractThe clinical presentation of lung disease is determined by the interaction between fungus and host. Invasive aspergillosis develops in severely immunocompromised patients, including those with neutropenia, and increasingly in the non-neutropenic host, including lung transplant recipients, the critically ill patients and patients on steroids. A high index of suspicion is required in patients without the classical risk factors as early presentation is usually silent and non-specific, pyrexia uncommon and timely treatment is crucial for survival. Invasive aspergillosis has also been diagnosed in normal hosts after massive exposure to fungal spores. Chronic pulmonary aspergillosis affects patients without obvious immune compromise, but with an underlying lung condition such as COPD or sarcoidosis, prior or concurrent TB or non-tuberculous mycobacterial disease. bronchitis may be responsible for persistent respiratory symptoms in patients with detected repeatedly in sputum without evidence of parenchymal disease, especially in patients with bronchiectasis and cystic fibrosis. Allergic bronchopulmonary aspergillosis affects patients with asthma and cystic fibrosis, and is important to recognise as permanent lung or airways damage may accrue if untreated. Changes in the classification of allergic lung disease have been proposed recently. Cases of extrinsic allergic alveolitis and chronic pulmonary aspergillosis have been observed after exposure. Asymptomatic colonisation of the respiratory tract needs close monitoring as it can lead to clinical disease especially with ongoing immunosuppression. The various syndromes should be viewed as a semicontinuous spectrum of disease and one form may evolve into another depending on the degree of ongoing immunosuppression.
pubBMJ Publishing Group Ltd and British Thoracic Society
doi10.1136/thoraxjnl-2014-206291
urlhttp://thorax.bmj.com/content/70/3/270.full.pdf
pmid25354514
pages270-277
date2015-03-01