Pulmonary Aspergillosis Flashcards
Species
A.fumigatus
Niger
Flavus
Spectrum
Simple colonization
Hsn rxn
Saprophytic growth
Invasive infection
Hsn reaction
Abpa
Bronchocentric granulomatosis
Extrinsic allergic alveoloitis
Allergic bronchial asthma
Invasive infection
Invasive bronchial aspergillosis Bronchial stump aspergillosis Invasive pulmonary Chronic pulmonary aspergillosis Ccpa Cnpa Cfpa
Aspergilloma classification
Primary - proliferation leads to cavity
Sec- growth in cavity/cyst
C/f
Hemoptysis
Xray
Monods sign
Air crescent sign
Tilt test
Diagnosis of aspergilloma
Radio Skin test Culture Ab to a.fumigatus Gms stain
Mx of aspergilloma
Surgical
Intracavitary antifungal amph-b , ketoconazole
Bae
Itraconazole 200- 400 day for 6 to 18 months
Vori if itra resistant
Ipa r/f
Pathogenesis
Lynphophenia
Global dysregulatioj of th1/2
Aspergillus mediated suppression of host th1 by gliotoxin
Proliferation
Diagnosis
Halo sign Air cresrnt sign Bal/biopsy- hpe, culture/ stain Galactomannan - blood and bal 1,3 beta d glucan- fp in cirrhosis/hd Pcr
Rx
Vori- 6mg bd 1day
4mg bd till improvement
Oral 200 bd
Liposomal- 3-5mg/kg
Salvage therapy
Caspo/posoconazole
When do u do sx
Pulm Infarction
Pul tissue sequestration not respondung to abx
Prophylaxis in whom n what
Posoconazole doc.200 mg qid with soda
Vori
In high risk transplant, neutropenic