Condition- Apergillus Lung Disease

Question 1

Name three different diseases caused by aspergillus

Answer 1

1. Aspergilloma
2. Allergic Brinchopulmonary Aspergillosis (ABPA)
3. Invasive Aspergillosis

Question 2

Describe how Aspergillus infects people

Answer 2

Aspergillus from the soil is inhaled as aerosolised conidia (spores) and causes the infection. Host immune impairment determines extent of disease

Question 3

What are the risk factors for developing invsaive aspergillosis?

Answer 3

Immunocompromised individuals

Question 4

What are the symptoms of aspergillosis?

Answer 4

• pleuritic chest pain
• pleural rub
• SOB/ dyspnoea
• cough
• Fever
• headache, Congestion/ sinus tenderness, cranial nerve palsy, seizures

Question 5

What are the signs of Asperillus lung disease?

Answer 5

• wheeze
• tracheal deviation (with large aspergillomas)
• Dullness in affected lung?
• Reduced breath sounds?
• Cyanosus (possible in IA)?

Question 6

Which part of the lungs do aspergillomas normally form?

Answer 6

The upper lobes of the lungs

Question 7

Why might patients with aspergillomas present with haemoptysis?

Answer 7

The aspergilloma might cause mechanical friction against bronchial vessels and erode the vessel walls

Question 8

How would you diagnose aspergillomas? and what would the positive results of these investigations be?

Answer 8

1. CXR- shows round mass with crescent of air around it, usually found in upper lobes
2. Chest CT scan- if CXR is unclear. Shows mass with adjacent pleural thickening

N.B. Sputum culture are usually negative if there is no interaction between cavity and bronchial tree

Question 9

List 3 key features of aspergillosis

Answer 9

• Bronchiectasis
• Bloods: eosinophilia
• CXR: rounded opacity + ring around it

Question 10

What would you see in the bloods of someone with apergillosis?

Answer 10

Eosinophillia