[12] Pulmonary Aspergillus Infections Flashcards
What diseases can be caused by pulmonary aspergillus infections?
Asthma Allergic bronchopulmonary aspergillosis (ABPA) Adpergilloma Invasive aspergillosis Extrinsic allergic alveolitis
How can pulmonary aspergillus infections lead to asthma?
T1HS reaction to spores
What is the pathophysiology of allergic bronchopulmonary aspergillosis (ABPA)?
T1 and T3 HS reaction to aspergillus fumigatus leads to bronchoconstriction, which leads to bronchiectasis
What are the symtoms of ABPA?
Wheeze
Productive cough
Dyspnoea
How is ABPA investigated?
CXR
Sputum culture
Aspergillus skin test or IgE RAST
Serum testing
What might be found on CXR in ABPA?
Bronchiectasis
How does aspergillus in sputum appear?
Black on silver stain
What will be found in serum testing in ABPA?
Positive serum precipitans
Increased IgE and eosinophils
How are acute attacks of ABPA managed?
Pred 40mg/day and itraconazole
What is used in maintenance management for ABPA?
Pred 5-10mg/day
Bronchodilators for asthma component
What is an aspergilloma?
A fungus ball within a pre-existing cavity
What might cause the pre-existing cavity in aspergilloma?
TB
Sarcoid
What are the clinical features of aspergilloma?
Usually asymptomatic, but can cause haemoptysis, lethargy, and weight loss
How severe is the haemoptysis in aspergilloma?
Can be severe
How is aspergilloma investigated?
CXR
Sputum culture
Serum testing
Aspergillus skin test/RAST