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https://www.readbyqxmd.com/read/29348280/marked-cachexia-in-probable-invasive-pulmonary-aspergillosis-with-bronchopleural-fistula
#1
Christiana Page, Laura Blazy, Melanie Jenkins, Rosalba Spiritoso
A 49-year-old man with a medical history of diabetes and heavy smoking was admitted to intensive care with severe bilateral pneumonia associated with marked cachexia. He developed a complex right-sided bronchopleural fistula and was transferred to our tertiary centre for consideration of surgical intervention.Despite escalation of antibiotic therapy, he did not improve and further investigations led to a diagnosis of invasive pulmonary aspergillosis. Definitive treatment plans required a right pneumonectomy; however, given the severity of cachexia, he remained unable to undergo such a large operation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29346411/evaluation-of-hirst-type-spore-traps-in-outdoor-aspergillaceae-monitoring-during-large-demolition-work-in-hospital
#2
Sophie Tiphaine Loeffert, Philippe Vanhems, Estelle Tissot, Cédric Dananché, Pierre Cassier, Thomas Bénet, Michel Perraud, Michel Thibaudon, Marie-Paule Gustin
Demolition can generate fungal spore suspensions in association with various adverse health effects, such as high risk of invasive aspergillosis in immunocompromised patients. One block of Edouard Herriot Hospital was entirely demolished. The aim of the present study was to evaluate Hirst-type spore traps utility in monitoring outdoor Aspergillaceae (Aspergillus spp. + Penicillium spp.) spores in part of Edouard Herriot Hospital (Lyon, France) undergoing major demolition. Three periods were scheduled in 2015: (A) Gutting of building and asbestos removal, (B) Demolition of floors, (C) Excavation and earthwork...
2018: PloS One
https://www.readbyqxmd.com/read/29346250/incidence-etiology-and-clinicopathologic-features-of-endobronchial-benign-lesions-a-10-year-consecutive-retrospective-study
#3
Alessandro Marchioni, Eleonora Casalini, Alessandro Andreani, Gaia Cappiello, Ivana Castaniere, Riccardo Fantini, Maria Cecilia Mengoli, Roberto Tonelli, Enrico M Clini, Giulio Rossi
BACKGROUND: Airways can be affected by non-neoplastic lesions leading to critical stenosis of the lumen. Incidence, etiology, and clinical significance of endobronchial benign lesions are not systematically characterized.This study aimed to assess the epidemiology of nonmalignant processes involving the bronchial tree on clinical, pathologic, endoscopic, and radiologic grounds. METHODS: We retrospectively analyzed bronchoscopy procedures over 10 years at the Bronchoscopy Unit of Modena University Hospital...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29345613/comparative-transcriptomics-of-aspergillus-fumigatus-strains-upon-exposure-to-human-airway-epithelial-cells
#4
Tonya N Watkins, Hong Liu, Matthew Chung, Tracy H Hazen, Julie C Dunning Hotopp, Scott G Filler, Vincent M Bruno
Aspergillus fumigatus is an opportunistic, ubiquitous, saprophytic mould that can cause severe allergic responses in atopic individuals as well as life-threatening infections in immunocompromised patients. A critical step in the establishment of infection is the invasion of airway epithelial cells by the inhaled fungi. Understanding how A. fumigatus senses and responds to airway cells is important to understand the pathogenesis of invasive pulmonary aspergillosis. Here, we analysed the transcriptomes of two commonly used clinical isolates, Af293 and CEA10, during infection of the A549 type II pneumocyte cell line in vitro...
January 18, 2018: Microbial Genomics
https://www.readbyqxmd.com/read/29343867/improving-survival-of-acute-on-chronic-liver-failure-patients-complicated-with-invasive-pulmonary-aspergillosis
#5
Jie Gao, Qing Zhang, Yuankui Wu, Ying Li, Tingting Qi, Congyan Zhu, Sijia Liu, Ruoxi Yu, Qinjun He, Weiqun Wen, Fuyuan Zhou, Yongpeng Chen, Jinjun Chen, Jinlin Hou
The mortality of acute-on-chronic liver failure (ACLF) patients complicated with invasive pulmonary aspergillosis (IPA) was extremely high. We aimed to explore prognostic value of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) lung score and to establish an optimal voriconazole regimen for ACLF patients complicated with IPA. We retrospectively screened hospitalized ACLF patients in our hospital from July 2011 to April 2016, from which 20 probable IPA cases were diagnosed. Along with onsets of IPA, deteriorated diseases severity, especially lung conditions were found in those 20 ACLF patients...
January 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29333407/the-limited-role-of-serum-galactomannan-assay-in-screening-for-invasive-pulmonary-aspergillosis-in-allogeneic-stem-cell-transplantation-recipients-on-micafungin-prophylaxis-a-retrospective-study
#6
Ryul Kim, Youngil Koh, Dong-Yeop Shin, Pyoeng Gyun Choe, Nam Joong Kim, Sung-Soo Yoon, Myoung-Don Oh, Wan Beom Park, Inho Kim
Background: We evaluated the outcomes of serum galactomannan (GM) assay for the screening of invasive pulmonary aspergillosis (IPA) in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients while on primary antifungal prophylaxis (PAP). Methods: This study included patients with hematologic disorders who underwent alloHSCT from January 2013 to November 2015. Patients received routine PAP with fluconazole before 2014 and micafungin after 2014; serum GM tests were performed and retrospectively analyzed...
December 2017: Blood Research
https://www.readbyqxmd.com/read/29331473/a-randomized-trial-of-itraconazole-versus-prednisolone-in-acute-stage-abpa-complicating-asthma
#7
Ritesh Agarwal, Sahajal Dhooria, Inderpaul Singh Sehgal, Ashutosh N Aggarwal, Mandeep Garg, Biman Saikia, Digambar Behera, Arunaloke Chakrabarti
BACKGROUND AND AIMS: Whether itraconazole monotherapy is effective in the acute-stage of allergic bronchopulmonary aspergillosis (ABPA) remains unknown. Herein, we compare the efficacy and safety of itraconazole and prednisolone monotherapy in ABPA. METHODS: We randomized treatment-naïve subjects with ABPA complicating asthma (January 2012 to December 2013) to receive either oral itraconazole or prednisolone for four months. The study was not blinded. The primary outcomes were proportion of subjects showing composite response after six weeks, percentage decline in IgE after treatment, and numbers of subjects experiencing exacerbation...
January 10, 2018: Chest
https://www.readbyqxmd.com/read/29327961/tracheal-resection-in-a-secretary-bird-sagittarius-serpentarius-with-granulomatous-foreign-body-induced-tracheitis
#8
Carsten Ludwig, Imke Lueders, Volker Schmidt, Hermann Kempf
A 24-year-old female secretary bird ( Sagittarius serpentarius) was presented with acute, mild dyspnea occurring only during feeding times. Despite initial conservative therapy consisting of antibiotics and antifungal, antiparasitic, and anti-inflammatory drugs, the dyspnea worsened progressively, resulting in severe respiratory distress. Radiographs of the trachea suggested stenosis in the caudal one-third of the trachea. Tracheal endoscopy revealed an obstruction of approximately 90% of the tracheal lumen, in addition to mild suspected aspergillosis of the air sacs...
December 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/29323188/a-tet-off-gene-expression-system-for-validation-of-antifungal-drug-targets-in-a-murine-invasive-pulmonary-aspergillosis-model
#9
Yutian Peng, Hua Zhang, Min Xu, Man-Wah Tan
Aspergillus fumigatus is one of the major causes of invasive pulmonary aspergillosis in immunocompromised patients. Novel antifungal therapy is in urgent need due to emerging resistance and adverse toxicity of current antifungal drugs. Gene products that are essential for Aspergillus viability during infection are attractive drug targets. To characterize these genes in vivo we developed a Tet-Off gene expression system in A. fumigatus, whereby the administration of doxycycline resulted in down regulation of the gene whose expression is under the control of the Tet-Off promoter...
January 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29322720/invasive-aspergillus-pseudomembranous-and-obstructive-tracheo-bronchitis-in-an-immuno-competent-patient
#10
Ramesh S Pal, Sonam Spalgais, Amit Kumar Murar, Umesh Chandra Ojha
A 19 year female, presented with life threatening haemoptysis and cough with minimum expectoration for 3 months. Bronchoscopy showed multiple nodules in airway. The direct microscopy and culture of sputum revealed fungal elements and Aspergillus flavus respectively. Serum Galactomannan was positive. Thus diagnosis of invasive aspergillus tracheo-bronchitis made. She responded to voriconazole. Aspergillus tracheo-bronchitis is a rare form of invasive pulmonary aspergillosis in immuno-competent host. Aspergillus spp in respiratory samples should not be routinely discarded as colonization...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29321933/acute-progression-of-aspergillosis-in-a-patient-with-lung-cancer-receiving-nivolumab
#11
Naohiro Uchida, Kohei Fujita, Koichi Nakatani, Tadashi Mio
A 65-year-old man with chronic progressive pulmonary aspergillosis (CPPA) was admitted for the treatment of lung adenocarcinoma while receiving an immune checkpoint inhibitor, nivolumab. The tumour responded well to the therapy, but the cavity of CPPA became large in contrast to the tumour after 20 courses of therapy. He was diagnosed as having exacerbation of CPPA and successfully and concurrently treated with an antifungal agent and nivolumab. Since there was absence of obvious immunosuppression and the presence of a drastic effect on tumour remission during nivolumab therapy, this phenomenon suggested that the trigger of CPPA progression was dependent not on immunosuppression but on a hyperreaction to microorganisms, which was similar to the immune reconstitution inflammatory syndrome caused by nivolumab...
February 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29314357/vitamin-d-levels-in-asthmatic-patients-with-and-without-allergic-bronchopulmonary-aspergillosis
#12
Ritesh Agarwal, Inderpaul S Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal, Naresh Sachdeva, Sanjay K Bhadada, Mandeep Garg, Digambar Behera, Arunaloke Chakrabarti
Vitamin D deficiency is believed to a pathogenetic factor in patients with allergic bronchopulmonary aspergillosis (ABPA) and cystic fibrosis. Whether vitamin D deficiency is also prevalent in ABPA complicating asthma, remains unknown. Herein, we evaluate vitamin D levels in asthmatic patients with and without ABPA. In a prospective study, plasma vitamin D (25[OH]D) levels were measured in consecutive subjects with asthma (n=75), ABPA (n=158) and healthy volunteers (n=50). Vitamin D levels <20 ng/mL were considered as vitamin D deficiency...
January 4, 2018: Mycoses
https://www.readbyqxmd.com/read/29311090/investigation-of-multiple-resistance-mechanisms-in-voriconazole-resistant-aspergillus-flavus-clinical-isolates-from-a-chest-hospital-surveillance-in-delhi-india
#13
Cheshta Sharma, Rakesh Kumar, Nitin Kumar, Aradhana Masih, Dinesh Gupta, Anuradha Chowdhary
Invasive and allergic infections by Aspergillus flavus are more common in tropical and subtropical countries. The emergence of voriconazole (VRC) resistance in A. flavus impacts the management of aspergillosis as azoles are used as the first line and empiric therapy. We screened molecularly confirmed 120 A. flavus isolates obtained from respiratory and sino-nasal specimens in a chest hospital in Delhi for azole resistance using CLSI BMD method. Overall, 2.5% (n=3/120) of A. flavus isolates had VRC MICs above epidemiological cutoff values (>1μg/ml)...
January 8, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29310381/primary-cutaneous-aspergillosis-caused-by-aspergillus-fumigatus-in-an-immunocompetent-patient-a-case-report
#14
Xiaoyan Liu, Jun Yang, Weiyuan Ma
RATIONALE: Primary cutaneous aspergillosis in immunocompromised patients has been well described in extensive investigations. However, in immunocompetent hosts, primary cutaneous infection of aspergillus occurs rarely, and remains poorly characterized. PATIENT CONCERNS: We present a case of primary cutaneous aspergillosis manifested by erythematous plague covered with flava eschar. DIAGNOSES: The patient was diagnosed with primary cutaneous aspergillosis...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29310378/isolated-cerebral-aspergillosis-in-an-immunocompetent-woman-on-treatment-for-bacterial-infected-necrotizing-pancreatitis-a-case-report
#15
Shaoyang Zhang, Qinghui Fu, Qi Chen, Ting-Bo Liang
RATIONALE: Cerebral aspergillosis (CA) is a rare manifestation of invasive aspergillosis. It usually affects seriously immunocompromised hosts. Pancreatic bacterial or/and fungal infection is common in patients with severe acute pancreatitis. PATIENT CONCERNS: We report the first case of an immunocompetent woman with infected necrotizing pancreatitis due to multidrug resistant Acinetobacter baumannii who, in the course of treatment, developed isolated CA. DIAGNOSES: Magnetic resonance imaging, rather than computed tomography, revealed latent homolateral sinus disease-the possible source of the Aspergillus infection...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29307928/spect-ct-with-radiolabeled-somatostatin-analogues-in-the-evaluation-of-systemic-granulomatous-infections
#16
Paulo Henrique Silva Monteiro, Thiago Ferreira de Souza, Maria Luiza Moretti, Mariangela Ribeiro Resende, Jair Mengatti, Mariana da Cunha Lopes de Lima, Allan Oliveira Santos, Celso Darío Ramos
Objective: To evaluate SPECT/CT with radiolabeled somatostatin analogues (RSAs) in systemic granulomatous infections in comparison with gallium-67 (67Ga) citrate scintigraphy. Materials and Methods: We studied 28 patients with active systemic granulomatous infections, including tuberculosis, paracoccidioidomycosis, pneumocystosis, cryptococcosis, aspergillosis, leishmaniasis, infectious vasculitis, and an unspecified opportunistic infection. Of the 28 patients, 23 had started specific treatment before the study outset...
November 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/29307752/a-2-year-comparative-study-of-mold-and-bacterial-counts-in-air-samples-from-neutral-and-positive-pressure-rooms-in-2-tertiary-care-hospitals
#17
Laura Ryan, Niall O'Mara, Sana Tansey, Tom Slattery, Belinda Hanahoe, Akke Vellinga, Maeve Doyle, Martin Cormican
Immunocompromised patients are at risk of invasive fungal infection. These high-risk patients are nursed in protective isolation to reduce the risk of nosocomial aspergillosis while in hospital-ideally in a positive pressure single room with high-efficiency particulate air filtration. However, neutral pressure rooms are a potential alternative, especially for patients requiring both protective and source isolation. This study examined mold and bacterial concentrations in air samples from positive and neutral pressure rooms to assess whether neutral pressure rooms offer a similar environment to that of positive pressure rooms in terms of mold concentrations in the air...
January 4, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29304212/use-of-echinocandin-prophylaxis-in-solid-organ-transplantation
#18
Maddalena Giannella, Shahid Husain, Faouzi Saliba, Pierluigi Viale
Invasive fungal infections (IFIs) are a major threat to patients undergoing solid organ transplantation (SOT). Owing to improvements in surgical techniques, immunosuppression therapy and antifungal prophylaxis, the incidence of IFIs has been decreasing in recent years. However, IFI-associated morbidity and mortality remain significant. Invasive candidiasis (IC) and aspergillosis (IA) are the main IFIs after SOT. Risk factors for IC and IA continue to evolve, and thus strategies for their prevention should be constantly updated and targeted to both individual patient risk factors and local epidemiology...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29283878/occupational-cns-aspergillosis-in-an-immunocompetent-individual-a-diagnostic-challange
#19
Parul Punia, Nidhi Goel, Ishwar Singh, Uma Chaudhary
INTRODUCTION: Immunocompetent individuals are rarely affected by Aspergillus species and its prime importance lies in immunocompromised patients where it can cause disease, ranging from primarily pulmonary infections to dissemination anywhere in the body. Invasive aspergillosis (IA) occurs in patients with risk factors including prolonged neutropenia, neutrophil dysfunction, patient on cytotoxic drugs, steroid therapy, hematological malignancy, AIDS or in patients with bone marrow transplantation...
December 28, 2017: Archives of Environmental & Occupational Health
https://www.readbyqxmd.com/read/29281994/successful-treatment-of-cerebral-aspergillosis-case-report-of-a-patient-with-t-cell-large-granular-lymphocytic-leukemia-t-lgl
#20
Amin T Turki, Jassin Rashidi-Alavijeh, Jan Dürig, Guido Gerken, Peter-Michael Rath, Oliver Witzke
BACKGROUND: Invasive aspergillosis involving patients with neutropenia or severe immunosuppression, such as patients with hematologic malignancies is associated with high mortality. Patients with T-cell large granular lymphocytic leukemia (T-LGL) on the other hand are considered to be less vulnerable for severe opportunistic fungal infection as their course of disease is chronic and marked by less violent cytopenia then in e.g. Aplastic Anemia. Only neutropenia is regarded as independent risk factor for severe opportunistic infection in T-LGL patients...
December 28, 2017: BMC Infectious Diseases
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