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ANKI Respiratory > [12] Pulmonary Aspergillus Infections > Flashcards

[12] Pulmonary Aspergillus Infections Flashcards

1
Q

What diseases can be caused by pulmonary aspergillus infections?

A 
Asthma
Allergic bronchopulmonary aspergillosis (ABPA)
Adpergilloma
Invasive aspergillosis
Extrinsic allergic alveolitis
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2
Q

How can pulmonary aspergillus infections lead to asthma?

A

T1HS reaction to spores

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3
Q

What is the pathophysiology of allergic bronchopulmonary aspergillosis (ABPA)?

A

T1 and T3 HS reaction to aspergillus fumigatus leads to bronchoconstriction, which leads to bronchiectasis

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4
Q

What are the symtoms of ABPA?

A

Wheeze
Productive cough
Dyspnoea

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5
Q

How is ABPA investigated?

A

CXR
Sputum culture
Aspergillus skin test or IgE RAST
Serum testing

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6
Q

What might be found on CXR in ABPA?

A

Bronchiectasis

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7
Q

How does aspergillus in sputum appear?

A

Black on silver stain

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8
Q

What will be found in serum testing in ABPA?

A

Positive serum precipitans

Increased IgE and eosinophils

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9
Q

How are acute attacks of ABPA managed?

A

Pred 40mg/day and itraconazole

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10
Q

What is used in maintenance management for ABPA?

A

Pred 5-10mg/day

Bronchodilators for asthma component

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11
Q

What is an aspergilloma?

A

A fungus ball within a pre-existing cavity

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12
Q

What might cause the pre-existing cavity in aspergilloma?

A

TB

Sarcoid

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13
Q

What are the clinical features of aspergilloma?

A

Usually asymptomatic, but can cause haemoptysis, lethargy, and weight loss

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14
Q

How severe is the haemoptysis in aspergilloma?

A

Can be severe

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15
Q

How is aspergilloma investigated?

A

CXR
Sputum culture
Serum testing
Aspergillus skin test/RAST

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16
Q

What may be found on CXR in aspergilloma?

A

Round opacity within a cavity, usually apical

17
Q

What might be found on serum testing in aspergilloma?

A

Positive serum precipitins

18
Q

How can aspergillomas be managed?

19
Q

When should excision be considered in aspergillomas?

A

Solitary lesions/severe haemoptysis

20
Q

What happens in invasive aspergillosis?

A

Aflatoxins lead to liver cirrhosis and hepatocellular carcinoma

21
Q

What are the risk factors for invasive aspergillosis?

A

Immunocompromisation

Post-broad spectrum Abx

22
Q

Give 3 examples of causes of immunocompromisation which can increase the risk of invasive aspergillosis

A

HIV
Leukaemia
Wegener’s granulomatosis

23
Q

How is invasive aspergillosis investigated?

A 
CXR
Sputum MC&S
BAL
Serum testing
Serial galactomannan
24
Q

What may be found on CXR in invasive aspergillosis?

A

Consolidation

Abscess

25
Q

How is invasive aspergillosis managed?

A

Voriconazole

26
Q

What is the prognosis of invasive aspergillosis?

A

30% mortality

27
Q

What happens in extrinsic allergic alveolitis?

A

A sensitivity to aspergillus clavatus causes Malt worker’s lung

ANKI Respiratory (17 decks)

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