Manifestations of pulmonary aspergillosis in pediatrics
Purpose of review Aspergillus spp. cause a clinical spectrum of disease with severity of disease dependent on degree of immune compromise, nature and intensity of inflammatory host response, and/or underlying lung disease. Chronic pulmonary aspergillosis encompasses a spectrum of diseases including aspergilloma, Aspergillus nodules, chronic cavitary pulmonary aspergillosis, chronic fibrosing pulmonary aspergillosis, and subacute invasive pulmonary aspergillosis. Allergic bronchopulmonary aspergillosis (ABPA) paradoxically is an immune hypersensitivity manifestation in the lungs that almost always occurs in the setting of underlying asthma or cystic fibrosis. These chronic Aspergillus conditions are now becoming more prevalent than invasive Aspergillus, thus it is important to be aware of the current literature of these conditions. Recent findings High-level research assessing the clinical significance and treatment options of these chronic diseases are lacking. Recent literature suggests colonization is antecedent for local airway infection (Aspergillus bronchitis), chronic or allergic bronchopulmonary disease, or invasive and potentially disseminated disease. There have been few advances in assessment of treatment of ABPA. Summary Research assessing the clinical significance and treatment options is currently needed.
Publication date: Available online 12 July 2020Source: International Journal of Pediatrics and Adolescent MedicineAuthor(s): Abdullah Al-Shamrani, Adel S. Al-Harbi, Alhaider SA, Saleh AlHarbi, Nasser S. Al-Harbi, Alnashmi Alanazi, Turki S. Al Ahmadi
Publication date: Available online 12 July 2020Source: Microbial PathogenesisAuthor(s): Pegah Ardi, Roshanak Daie-Ghazvini, Seyed Jamal Hashemi, Mohammad Reza Salehi, Heidar Bakhshi, Zahra Rafat, Kazem Ahmadikia, Mahdi Zareei, Muhammad Getso, Solmaz Basiri, Hasti Kamali Sarwestani, Zeinab Borjian Boroujeini
Publication date: Available online 11 July 2020Source: Research in Veterinary ScienceAuthor(s): Emily A. Sundman, Munashe Chigerwe, Laszlo M. Hunyadi
The absence of cystic fibrosis transmembrane regulator (CFTR) protein function results in dehydration of airway secretions in patients with CF . Over time, CF airway secretions progressively obstruct airway lumens and serve as the nidus of chronic airway infection. Strategies that reverse airway service liquid (ASL) dehydration and support mucus transport, therefore, address the primary pathogenesis of CF lung disease and are expected to improve clinical outcomes .
Obesity is a highly prevalent condition worldwide that aggravates symptoms of already existing conditions such as asthma and COPD. The limited effectiveness of inhaled medications in these individuals may be related to anatomic characteristics of their upper airways, mainly due to compressive factors.
Conclusions: Negative ICS beliefs are associated with higher number of oral steroid courses. The association between CAM endorsement and asthma control is varied, but mostly in favor of improved control. Financial difficulties may make CAM use more likely. PMID: 32646322 [PubMed - as supplied by publisher]
CONCLUSION: The use of multiple recombinant antigens may improve the diagnostic accuracy in CF complicated with ABPA or AB. Asp f1 reactivity may relate to the presence of actively growing Aspergillus spp., which might be a useful marker for guiding antifungal therapy in ABPA. PMID: 31090534 [PubMed - as supplied by publisher]
This article is an abridged version of the AWMF mould guideline “Medical clinical diagnostics of indoor mould exposure” presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft f ür Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has ye...
Aspergillus fumigatus is a ubiquitous, filamentous and spore-bearing fungus which usually grows at 37 degrees Celsius. It can be an opportunistic pathogen and can induce an inflammatory response in the airways through the production of various toxic and allergenic exoproducts. As a consequence, the clinical presentation may take a number of forms: Allergic bronchopulmonary aspergillosis (ABPA), aspergillus bronchitis, invasive pulmonary aspergillosis and an aspergilloma. ABPA occurs almost exclusively in asthma or cystic fibrosis (CF) patients .
The clinical presentation of Aspergillus 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...