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invasive pulmonary aspergillosis

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https://www.readbyqxmd.com/read/29153975/optimisation-of-empirical-antimicrobial-therapy-in-patients-with-haematological-malignancies-and-febrile-neutropenia-how-long-study-an-open-label-randomised-controlled-phase-4-trial
#1
Manuela Aguilar-Guisado, Ildefonso Espigado, Almudena Martín-Peña, Carlota Gudiol, Cristina Royo-Cebrecos, José Falantes, Lourdes Vázquez-López, María Isabel Montero, Clara Rosso-Fernández, María de la Luz Martino, Rocío Parody, José González-Campos, Sebastián Garzón-López, Cristina Calderón-Cabrera, Pere Barba, Nancy Rodríguez, Montserrat Rovira, Enrique Montero-Mateos, Jordi Carratalá, José Antonio Pérez-Simón, José Miguel Cisneros
BACKGROUND: Continuation of empirical antimicrobial therapy (EAT) for febrile neutropenia in patients with haematological malignancies until neutrophil recovery could prolong the therapy unnecessarily. We aimed to establish whether EAT discontinuation driven by a clinical approach regardless of neutrophil recovery would optimise the duration of therapy. METHODS: We did an investigator-driven, superiority, open-label, randomised, controlled phase 4 clinical trial in six academic hospitals in Spain...
November 15, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/29151911/multiple-pulmonary-metastases-with-halo-sign-from-malignant-mixed-m%C3%A3-llerian-tumors
#2
Hong-Wei Tian, Wei-Bing Yang, Meng-Jie Yang, Jing-Yuan Liu, Jian-Chu Zhang, Xiao-Nan Tao, Qiong Zhou
The lungs are one of the most common organs to which cancer metastasizes, but are a location not common for uterine sarcoma. A malignant mixed Müllerian tumor (MMMT) of the uterus is an extremely rare and aggressive sarcoma, characterized by a mixture of epithelial and mesenchymal components. There are few reports regarding the pulmonary metastasis from MMMTs. The present study presents the case of a 58-year-old woman with hemoptysis and post-menopausal vaginal bleeding. The woman was initially diagnosed with invasive aspergillosis based on a chest computed tomography (CT) scan showing multiple pulmonary nodular opacities surrounded by a ground-glass attenuation halo (halo-sign)...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29150592/the-influence-of-genetic-stability-on-aspergillus-fumigatus-virulence-and-azole-resistance
#3
Thaila Fernanda Dos Reis, Lilian Pereira Silva, Patrícia Alves de Castro, Pollyne Borborema Almeida de Lima, Rafaela Andrade do Carmo, Marjorie Mendes Marini, José Franco da Silveira, Beatriz Henriques Ferreira, Fernando Rodrigues, Iran Malavazi, Gustavo H Goldman
Genetic stability is extremely important for the survival of every living organism and a very complex set of genes have evolved to cope with DNA repair upon DNA damage. Here, we investigated the Aspergillus fumigatus AtmA (Ataxia-telangiectasia mutated) and AtrA kinases and how they impact virulence and the evolution of azole resistance. We demonstrated that A. fumigatus atmA and atrA null mutants are haploid and have a discrete chromosomal polymorphism. The ΔatmA and ΔatrA strains are sensitive to several DNA damaging agents but surprisingly both strains were more resistant than the wild-type strain to paraquat, menadione, and hydrogen peroxide...
November 17, 2017: G3: Genes—Genomes—Genetics
https://www.readbyqxmd.com/read/29128933/proven-invasive-pulmonary-aspergillosis-in-stem-cell-transplant-recipient-due-to-aspergillus-sublatus-a-cryptic-species-of-a-nidulans
#4
Vanda Chrenkova, Vit Hubka, Petr Cetkovsky, Michal Kouba, Barbora Weinbergerova, Pavlina Lyskova, Ludmila Hornofova, Petr Hubacek
Invasive fungal disease represents one of the severe complications in haematopoietic stem cell transplant recipients. We describe a case of a patient treated for relapse of chronic lymphoblastic leukaemia 6 years after HSCT. The patient was treated for invasive pulmonary aspergillosis but died 3 months later from multiple organ failures consisting of haemorrhagic necrotizing fungal pneumonia, refractory chronic hepatic graft versus host disease and cytomegalovirus hepatitis. Autopsy samples revealed histopathological evidence of fungal hyphae and an unusual Aspergillus nidulans-like species was isolated in pure culture...
November 11, 2017: Mycopathologia
https://www.readbyqxmd.com/read/29125713/outbreak-of-invasive-aspergillosis-in-heart-transplant-recipients-the-role-of-screening-computed-tomography-scans-in-asymptomatic-patients-and-universal-antifungal-prophylaxis
#5
Dima Kabbani, Livia Goldraich, Heather Ross, Coleman Rotstein, Shahid Husain
BACKGROUND: Delays in diagnosing invasive pulmonary aspergillosis (IA), a significant cause of morbidity and mortality among heart transplant recipients (HTRs), may impact on successful treatment. The appropriate screening strategy for IA in these patients remains undefined, particularly in the setting of nosocomial outbreaks. We describe our experience employing chest computed tomography (CT) scans as a screening method for IA. In addition, we comment on antimicrobial prophylaxis in HTRs in the setting of an outbreak...
November 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29125660/primary-prophylaxis-of-invasive-fungal-infections-with-posaconazole-or-itraconazole-in-patients-with-acute-myeloid-leukemia-or-high-risk-myelodysplastic-syndromes-undergoing-intensive-cytotoxic-chemotherapy-a-real-world-comparison
#6
Mar Tormo, Ariadna Pérez-Martínez, Marisa Calabuig, Juan Carlos Hernández-Boluda, Paula Amat, David Navarro, Carlos Solano
This is an observational-retrospective study comparing the real-world outcomes associated with posaconazole vs. itraconazole as prophylaxis treatments. Two hundred and ninety-three patient admissions attributable to 174 patients were included in the study. Patients were treated with itraconazole (n = 114 admissions; 39%) or posaconazole (n = 179; 61%). Antifungal prophylaxis failure (APF) due to treatment-related adverse events (in 34 out of 293 patient admissions; 11.6%) was more frequent in the posaconazole group (6...
November 10, 2017: Mycoses
https://www.readbyqxmd.com/read/29112326/real-world-challenges-and-unmet-needs-in-the-diagnosis-and-treatment-of-suspected-invasive-pulmonary-aspergillosis-in-patients-with-hematological-diseases-an-illustrative-case-study
#7
Martin Hoenigl, Juergen Prattes, Peter Neumeister, Albert Wölfler, Robert Krause
Recent years have seen important advances in the diagnosis of invasive pulmonary aspergillosis (IPA), complemented by the introduction of new therapies. Despite this, IPA remains a major cause of infection-related mortality in patients with hematological diseases. There are two main reasons for this. First, diagnosis of IPA remains a challenge, since risk factors and the clinical, radiological and mycological presentations vary not only by fungal disease stage, but also by patient group (e.g. neutropenic versus non-neutropenic patients)...
November 7, 2017: Mycoses
https://www.readbyqxmd.com/read/29102972/urinary-tract-aspergillosis-in-a-patient-with-chronic-kidney-disease
#8
Linghong Zhou, Huazhen Zhao, Zhongqing Chen, Liping Zhu
Invasive aspergillosis is a life-threatening fungal infection, especially in immunocompromised patients. Pulmonary aspergillosis is the most common type of the infection, while urinary tract infection is relatively rare. Here, we describe a case of a 46-year-old man with chronic renal disease presenting with intermittent abdominal pain. The diagnosis of aspergillosis was established by pathological findings of the fungal ball in the bladder. The patient underwent multiple antimicrobial treatments and surgical interventions and was finally cured by posaconazole...
November 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29081110/-coal-workers-s-pneumoconiosis-combined-with-invasive-pulmonary-aspergillosis-a-case-report
#9
Y R Wang, Q Ye
No abstract text is available yet for this article.
July 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/29075583/invasive-aspergillosis-involving-the-mediastinum-in-an-immunocompetent-patient-a-case-report
#10
Manesh Kumar Gangwani, Muhammad Aziz, Siraj Munir, Syed Ahsan Ali
We report a rare case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 38-year-old female was hospitalized for cough, shortness of breath and fever. She had a past medical history of tuberculosis. Computed tomography (CT) scans identified an ill-defined enhancing mediastinal soft tissue density mass encasing the heart and major vessels. The cardiac echocardiography showed global hypokinesia, low ejection fraction and a large echogenic density in the left atrium. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which were stained with periodic Acid-Schiff and Gomori's methenamine silver...
August 24, 2017: Curēus
https://www.readbyqxmd.com/read/29067630/pulmonary-aspergillus-overlap-syndromes
#11
Liyang Li, Zhilong Jiang, Changzhou Shao
BACKGROUND: Broadly, there are three main categories in pulmonary aspergillosis: chronic forms of aspergillosis; allergic bronchopulmonary aspergillosis; and invasive aspergillosis (IPA). IPA has been further subdivided into angioinvasive and airway-invasive aspergillosis. Aspergillus overlap syndromes is defined as the occurrence of more than one form aspergillus disease in a single individual. OBJECTIVES: To help clinicians correctly deal with AOS. METHODS: Retrospectively study the clinical findings of nine patients presenting with AOS...
October 24, 2017: Mycopathologia
https://www.readbyqxmd.com/read/29052351/analysis-of-the-clinical-features-of-invasive-bronchopulmonary-aspergillosis
#12
Yueqin Cao, Changzhou Shao, Yuanlin Song
INTRODUCTION: Early diagnosis of invasive bronchopulmonary aspergillosis (IBPA) is difficult, so the mortality rate is high. OBJECTIVE: To discuss the clinical features of IBPA. METHODS: We retrospectively analyzed the clinical features, imaging findings, laboratory test, diagnosis, and treatment of 115 patients with IBPA diagnosed from October 2004 to June 2013 in Zhongshan Hospital, Fudan University. RESULTS: The main clinical manifestations were cough in 58 patients (50...
October 20, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29049319/clinical-outcome-and-prognostic-factors-associated-with-invasive-pulmonary-aspergillosis-an-11-year-follow-up-report-from-taiwan
#13
Kuo-Shao Sun, Ching-Fang Tsai, Solomon Chih-Cheng Chen, Wan-Chun Huang
BACKGROUND: Invasive pulmonary aspergillosis (IPA) has high mortality rate but prognostic factors are not well established. The aim of our study was to evaluate the trend in in-hospital mortality over a period of 11 years and identify factors affecting the clinical outcomes of patients with IPA. METHOD: We conducted a nationwide inpatient population study using data from the Taiwan National Health Insurance Research Database. A total of 407 IPA patients from 2002 to 2012 were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/29049239/clinical-features-and-diagnosis-of-chronic-pulmonary-aspergillosis-in-chinese-patients
#14
Xiaomeng Hou, Hong Zhang, Lei Kou, Wei Lv, Jingjing Lu, Ji Li
Chronic pulmonary aspergillosis (CPA) has recently been recognized as a significant global health burden. In China, the diagnosis of CPA is still unfamiliar to most doctors. The aim of this study was to demonstrate the clinical manifestations and diagnoses of CPA in China.A multidisciplinary team of doctors retrospectively screened 690 records of patients diagnosed with pulmonary aspergillosis from January 2000 to December 2016 at Peking Union Medical College Hospital, Beijing, China. Of these, 69 patients were diagnosed with CPA...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049191/significance-of-monitoring-plasma-concentration-of-voriconazole-in-a-patient-with-liver-failure-a-case-report
#15
Xiaoyan Liu, Haibin Su, Jingjing Tong, Jing Chen, Haozhen Yang, Long Xiao, Jinhua Hu, Lina Zhang
RATIONALE: Invasive pulmonary aspergillosis is associated with significant morbidity and mortality in patients with liver failure. Voriconazole (VRCZ) is recommended as a primary therapeutic agent for the treatment of invasive aspergillosis and metabolized in the liver. Now, data are still lacking on the safety and appropriate dosage of VRCZ in patients with liver failure. Here, we report a representative case of invasive pulmonary fungal infection in a patient with liver failure who was treated with low-dose VRCZ...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29020397/pentraxin-3-gene-polymorphisms-and-pulmonary-aspergillosis-in-copd-patients
#16
Qian He, Hongxing Li, Yuwen Rui, Lulu Liu, Binchan He, Yi Shi, Xin Su
Background: Pentraxin 3 (PTX3) plays an important role in resistance to Aspergillus infections. Previous studies have suggested that PTX3 polymorphisms influence the risk of invasive aspergillosis among transplantation recipients. This study was to investigate the association between PTX3 gene polymorphisms and pulmonary aspergillosis in chronic obstructive pulmonary disease (COPD) population. Methods: We included 173 consecutive inpatients with COPD. 36 cases were finally diagnosed with pulmonary aspergillosis...
August 19, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28986661/-aspergillus-in-airway-material-ignore-or-treat
#17
REVIEW
H J F Salzer, C Lange, M Hönigl
Fungi of the genus Aspergillus are ubiquitously present. Even though humans inhale Aspergillus spores daily under natural conditions, Aspergillus-associated pulmonary diseases only occur under special circumstances. Whether an Aspergillus-associated disease develops and which type of Aspergillus-associated disease develops depends on the constitution of the host. The spectrum of Aspergillus-associated pulmonary diseases ranges from allergic diseases, such as hypersensitivity pneumonitis to allergic infectious diseases, such as allergic bronchopulmonary aspergillosis (ABPA) and bronchocentric granulomatosis (BG) to infectious diseases, such as invasive (IA) or semi-invasive aspergillosis (SIA) and chronic pulmonary aspergillosis (CPA)...
November 2017: Der Internist
https://www.readbyqxmd.com/read/28986419/type-iii-interferon-is-a-critical-regulator-of-innate-antifungal-immunity
#18
Vanessa Espinosa, Orchi Dutta, Constance McElrath, Peicheng Du, Yun-Juan Chang, Bryan Cicciarelli, Amy Pitler, Ian Whitehead, Joshua J Obar, Joan E Durbin, Sergei V Kotenko, Amariliz Rivera
Type III interferons (IFN-λs) are the most recently found members of the IFN cytokine family and engage IFNLR1 and IL10R2 receptor subunits to activate innate responses against viruses. We have identified IFN-λs as critical instructors of antifungal neutrophil responses. Using Aspergillus fumigatus (Af) as a model to study antifungal immune responses, we found that depletion of CCR2(+) monocytes compromised the ability of neutrophils to control invasive fungal growth. Using an unbiased approach, we identified type I and III IFNs as critical regulators of the interplay between monocytes and neutrophils responding to Af We found that CCR2(+) monocytes are an important early source of type I IFNs that prime optimal expression of IFN-λ...
October 6, 2017: Science Immunology
https://www.readbyqxmd.com/read/28966482/comparative-evaluation-of-galactomannan-test-with-bronchoalveolar-lavage-and-serum-for-the-diagnosis-of-invasive-aspergillosis-in-patients-with-hematological-malignancies
#19
Ankit Gupta, Malini R Capoor, Trupti Shende, Bhawna Sharma, Ritin Mohindra, Jagdish Chander Suri, Dipender Kumar Gupta
INTRODUCTION: Invasive pulmonary aspergillosis (IPA) is a major cause of morbidity and mortality in patients with hematological malignancies. In recent years, testing for values of galactomannan (GM) in serum and bronchoalveolar lavage (BAL) fluid has been investigated as a diagnostic test for IPA for such patients, but global experience and consensus on optical density (OD) cutoffs, especially for BAL galactomannan remains lacking. METHODS: We performed a prospective case-control study to determine an optimal BAL GM OD cutoff for IPA in at-risk patients...
October 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28951444/quantitative-analysis-of-proteome-modulations-in-alveolar-epithelial-type-ii-cells-in-response-to-pulmonary-aspergillus-fumigatus-infection
#20
Pegah Seddigh, Thilo Bracht, Valerie Molinier-Frenkel, Flavia Castellano, Olaf Kniemeyer, Marc Schuster, Juliane Weski, Anja Hasenberg, Andreas Kraus, Gernot Poschet, Thomas Hager, Dirk Theegarte, Christiane Opitz, Axel A Brakhage, Barbara Sitek, Mike Hasenberg, Matthias Gunzer
The ubiquitous mold Aspergillus fumigatus threatens immunosuppressed patients as inducer of lethal invasive aspergillosis. A. fumigatus conidia are airborne and reach the alveoli, where they encounter alveolar epithelial cells (AEC). Previous studies reported the importance of the surfactant-producing AEC II during A. fumigatus infection via in vitro experiments using cell lines. We established a negative isolation protocol yielding untouched primary murine AEC II with a purity >90 %, allowing ex vivo analyses of the cells, which encountered the mold in vivo...
September 26, 2017: Molecular & Cellular Proteomics: MCP
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