scholarly journals Chronic pulmonary aspergillosis in a patient with hyper‐ IgE syndrome

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Keisuke Kasuga ◽  
Keitaro Nakamoto ◽  
Kazuyuki Doi ◽  
Nozomi Kurokawa ◽  
Takeshi Saraya ◽  
...  
Keyword(s):  
Pulmonary Aspergillosis ◽  
Hyper Ige Syndrome ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard Kwizera ◽  
Andrew Katende ◽  
Felix Bongomin ◽  
Lydia Nakiyingi ◽  
Bruce J. Kirenga
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Diagnostic Criteria ◽  
Tertiary Care ◽  
Chest Imaging ◽  
Resource Limited Settings ◽  
Pulmonary Aspergillosis ◽  
Resource Limited ◽  
Chronic Pulmonary Aspergillosis ◽  
Hiv Negative

Abstract Background Diagnosis of chronic pulmonary aspergillosis (CPA) is based on a combination of clinical symptomatology, compatible chest imaging findings, evidence of Aspergillus infection and exclusion of alternative diagnosis, all occurring for more than 3 months. Recently, a rapid, highly sensitive and specific point-of-care lateral flow device (LFD) has been introduced for the detection of Aspergillus-specific immunoglobulin (Ig)G, especially in resource-limited settings where CPA is underdiagnosed and often misdiagnosed as smear-negative pulmonary tuberculosis (PTB). Therefore, in our setting, where tuberculosis (TB) is endemic, exclusion of PTB is an important first step to the diagnosis of CPA. We used the recently published CPA diagnostic criteria for resource-limited settings to identify patients with CPA in our center. Case presentation Three Ugandan women (45/human immunodeficiency virus (HIV) negative, 53/HIV infected and 18/HIV negative), with a longstanding history of cough, chest pain, weight loss and constitutional symptoms, were clinically and radiologically diagnosed with PTB and empirically treated with an anti-tuberculous regimen despite negative microbiological tests. Repeat sputum Mycobacteria GeneXpert assays were negative for all three patients. On further evaluation, all three patients met the CPA diagnostic criteria with demonstrable thick-walled cavities and fungal balls (aspergilomas) on chest imaging and positive Aspergillus-specific IgG/IgM antibody tests. After CPA diagnosis, anti-TB drugs were safely discontinued for all patients, and they were initiated on capsules of itraconazole 200 mg twice daily with good treatment outcomes. Conclusions The availability of simple clinical diagnostic criteria for CPA and a LFD have the potential to reduce misdiagnosis of CPA and in turn improve treatment outcomes in resource-limited settings.

scholarly journals Performance of LDBio Aspergillus WB and ICT Antibody Detection in Chronic Pulmonary Aspergillosis

2021 ◽  
Vol 7 (4) ◽  
pp. 311
Author(s):  
Anna Rozaliyani ◽  
Findra Setianingrum ◽  
Sresta Azahra ◽  
Asriyani Abdullah ◽  
Ayu Eka Fatril ◽  
...  
Keyword(s):  
Receiver Operating Curve ◽  
Antibody Detection ◽  
Pulmonary Aspergillosis ◽  
Comparative Performance ◽  
Tuberculosis Patients ◽  
Chronic Pulmonary Aspergillosis ◽  
Screening Assays ◽  
Roc Area ◽  
Flow Detection ◽  
Sensitivity Specificity

The detection of Aspergillus antibody has a key role in the diagnosis of chronic pulmonary aspergillosis. Western blot (WB) and immunochromatography (ICT) lateral flow detection of Aspergillus antibody can be used as confirmatory and screening assays but their comparative performance in TB patients is not known. This study investigated the performance of these assays among 88 post-tuberculosis patients with suspected CPA. Sensitivity, specificity, receiver operating curve (ROC), area under-curve (AUC) and the agreement between two assays were evaluated. Both WB and ICT showed good sensitivity (80% and 85%, respectively) for detection of Aspergillus antibodies. Substantial agreement (0.716) between these assays was also obtained. The highest AUC result (0.804) was achieved with the combination of WB and ICT. The global intensity of WB correlated with the severity of symptoms in CPA group (p = 0.001). The combination of WB and ICT may increase specificity in CPA diagnosis.

scholarly journals Effect of patient immunodeficiencies on the diagnostic performance of serological assays to detect Aspergillus-specific antibodies in chronic pulmonary aspergillosis

2021 ◽  
Vol 178 ◽  
pp. 106290
Author(s):  
Elizabeth Stucky Hunter ◽  
Bayu Wilopo ◽  
Malcolm D. Richardson ◽  
Chris Kosmidis ◽  
David W. Denning
Keyword(s):  
Diagnostic Performance ◽  
Pulmonary Aspergillosis ◽  
Specific Antibodies ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Bronchoalveolar lavage galactomannan for the diagnosis of chronic pulmonary aspergillosis

2012 ◽  
Vol 50 (8) ◽  
pp. 811-817 ◽  
Author(s):  
Koichi Izumikawa ◽  
Yoshihiro Yamamoto ◽  
Tomo Mihara ◽  
Takahiro Takazono ◽  
Yoshitomo Morinaga ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

Evaluation of a quantitative serumAspergillus fumigatus-specific IgM assay for diagnosis of chronic pulmonary aspergillosis

2018 ◽  
Vol 12 (11) ◽  
pp. 2566-2572 ◽  
Author(s):  
Yake Yao ◽  
Hua Zhou ◽  
Yihong Shen ◽  
Qing Yang ◽  
Jian Ye ◽  
...  
Keyword(s):  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Impact of liposomal amphotericin B therapy on chronic pulmonary aspergillosis

2016 ◽  
Vol 73 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Pippa J. Newton ◽  
Chris Harris ◽  
Julie Morris ◽  
David W. Denning
Keyword(s):  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Liposomal Amphotericin B ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Chronic Pulmonary Aspergillosis Misdiagnosed as Smear-Negative Pulmonary Tuberculosis in a TB Clinic in Nigeria

2018 ◽  
Vol 26 (10) ◽  
pp. 1-5 ◽  
Author(s):  
Titilola Gbaja-Biamila ◽  
Felix Bongomin ◽  
Nicholas Irurhe ◽  
Augustina Nwosu ◽  
Rita Oladele
Keyword(s):  
Pulmonary Tuberculosis ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis ◽  
Smear Negative
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