Fungi and the lung Flashcards
how can aspergillus affect the lung
asthma, allergic bronchopulmonary aspergillosis, aspergilloma, invasive aspergillosis, extrinsic allergic alveolitis
how does aspergillus cause asthma
type 1 hypersensitivity reaction to fungal spores
what is allergic bronchopulmonary aspergillosis
from type 1 and 3 hypersensitivity to aspergillus fumigatus. allergic response causes bronchoconstriction, inflammation, permanent damage causing bronchiectasis
symptoms APBA
wheeze, cough, sputum, dyspnoea, recurrent pneumonia
investigations APBA
CXR- collapse, consolidation, bronchiectasis. aspergillus in sputum, positive aspergillus skin test and specific IgE RAST, raised serum IgE, eosinophilia
treatment APBA
prednisolone 30-40mg acute, 5-10mg maintenance. itraconazole, corticosteroids. bronchodilators.
what is an aspergilloma
fungus ball within a pre existing cavity which is often caused by TB or sarcoidosis
symptoms aspergilloma
usually asymptomatic but may cause cough, haemoptysis, lethargy, weight loss.
investigations aspergilloma
CXR- round opacity within a cavity usually apical, sputum culture, strongly positive serum precipitins. aspergillus skin test
treatment aspergilloma
only if symptomatic. surgical excision. itroconazole, amphotericin paste
risk factors of invasive aspergillosis
immunocompromise
investigations aspergillosis
sputum culture, BAL, biopsy, serum precipitins, CXR- consolidation, abscess; chest CT
what is the aspergillus antigen
galactomannan
treatment invasive aspergillosis
voriconazole. prognosis is 30% mortality
what is extrinsic allergic alveolitis
sensitivity to aspergillus claatus.
