scholarly journals Multidimensional Volumetric Imaging of Pulmonary Infiltrates for Measuring Therapeutic Response to Antifungal Therapy in Experimental Invasive Pulmonary Aspergillosis

2006 ◽  
Vol 50 (4) ◽  
pp. 1510-1517 ◽  
Author(s):  
Vidmantas Petraitis ◽  
Ruta Petraitiene ◽  
Jeffrey Solomon ◽  
Amy M. Kelaher ◽  
Heidi A. Murray ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Antifungal Therapy ◽  
Therapeutic Response ◽  
Invasive Pulmonary Aspergillosis ◽  
Therapeutic Monitoring ◽  
Pulmonary Aspergillosis ◽  
Volumetric Imaging ◽  
Treatment Groups ◽  
Pulmonary Infiltrates ◽  
Conventional Ct

ABSTRACT Pulmonary infiltrates in neutropenic hosts with invasive pulmonary aspergillosis are caused by vascular invasion, hemorrhagic infarction, and tissue necrosis. Monitoring the dynamics of pulmonary infiltrates of invasive aspergillosis is an important tool for assessing response to antifungal therapy. We, therefore, introduced a multidimensional volumetric imaging (MDVI) method for analysis of the response of the volume of pulmonary infiltrates over time to antifungal therapy in experimental invasive pulmonary aspergillosis (IPA) in persistently neutropenic rabbits. We developed a semiautomatic method to measure the volume of lung lesions, which was implemented as an extension of the MEDx visualization and analysis software using ultrafast computerized tomography (UFCT). Volumetric infiltrate measures were compared with UFCT reading, histopathological resolution of lesions, microbiological clearance of Aspergillus fumigatus, and galactomannan index (GMI). We also studied the MDVI method for consistency and reproducibility in comparison to UFCT. Treatment groups consisted of deoxycholate amphotericin B (DAMB) at 0.5 or 1 mg/kg of body weight/day and untreated controls (UC). Therapeutic monitoring of pulmonary infiltrates using MDVI demonstrated a significant decrease in the infiltrate volume in DAMB-treated rabbits in comparison to UC (P ≤ 0.001). Volumetric data by MDVI correlated with conventional CT pulmonary scores (r = 0.83, P ≤ 0.001). These results correlated with validated biological endpoints: pulmonary infarct scores (r = 0.85, P ≤ 0.001), lung weights (r = 0.76, P ≤ 0.01), residual fungal burden (r = 0.65, P ≤ 0.05), and GMI (r = 0.78, P ≤ 0.01). MDVI correlated with key biological markers, improved the objectivity of radiological assessment of therapeutic response to antifungal therapy, and warrants evaluation for monitoring therapeutic response in immunocompromised patients with invasive aspergillosis.

scholarly journals The outcome of two patients with myeloblastic acute leukemia and invasive pulmonary aspergillosis using clinical adjustment of Voriconazol therapy

2015 ◽  
Vol 10 (1) ◽  
pp. 62-66
Author(s):  
Ana-Maria NEAGU ◽  
◽  
Ana Maria VLĂDĂREANU ◽  
Horia BUMBEA ◽  
Diana CÎŞLEANU ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Invasive Aspergillosis ◽  
Antifungal Therapy ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Young Patients ◽  
Favourable Outcome ◽  
Invasive Fungal Infections ◽  
Severe Neutropenia ◽  
Pulmonary Aspergillosis

Background. Patients with acute leukemia are at high risk to develop invasive fungal infections, and Aspergillus spp is the most common pathogen. Aim. The two cases that are presented highlight the importance of adjusting the algorithm for diagnosis and treatment of invasive fungal infections in acute leukemia patients according to the particularities of each case in order to obtain an optimal response to the antifungal therapy. Methods and results. We present two cases of acute leukemia in young patients, who develop pulmonary invasive aspergillosis during severe neutropenia following chemotherapy. The diagnosis is clinical, mycrobiological, and esspecially imagistic, the CT scan revealing images typical for pulmonary invasive aspergillosis and allowing early antifungal therapy. Conclusions. The two cases illustrate the favourable outcome of patients with acute leukemia and pulmonary invasive aspergillosis when treated early with Voriconazole and the importance of dose adjusting according to clinical evolution.

Invasive Pulmonary Aspergillosis after Liver Transplantation: Rapid and Complete Response to Combined and Sequential Antifungal Therapy

2008 ◽  
Vol 9 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Mehmet Fatih Can ◽  
Gokhan Yagci ◽  
Levent Gorenek ◽  
Ergun Tozkoparan ◽  
Ismail Ozerhan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Antifungal Therapy ◽  
Invasive Pulmonary Aspergillosis ◽  
Complete Response ◽  
Pulmonary Aspergillosis

scholarly journals Invasive aspergillosis with disseminated skin ınvolvement in a patient with acute myeloid leukemia: a rare case

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Duygu Mert ◽  
Gülşen Iskender ◽  
Fazilet Duygu ◽  
Alparslan Merdin ◽  
Mehmet Sinan Dal ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Invasive Aspergillosis ◽  
Myeloid Leukemia ◽  
Rare Case ◽  
Invasive Pulmonary Aspergillosis ◽  
Skin Lesions ◽  
Immunocompromised Patients ◽  
Skin Involvement ◽  
Pulmonary Aspergillosis ◽  
Acute Myeloid

Invasive pulmonary aspergillosis is most commonly seen in immunocompromised patients. Besides, skin lesions may also develop due to invasive aspergillosis in those patients. A 49-year-old male patient was diagnosed with acute myeloid leukemia. The patient developed bullous and zosteriform lesions on the skin after the 21st day of hospitalization. The skin biopsy showed hyphae. Disseminated skin aspergillosis was diagnosed to the patient. Voricanazole treatment was initiated. The patient was discharged once the lesions started to disappear.

Invasive pulmonary aspergillosis/pseudomonas

2021 ◽  
Vol 14 (7) ◽  
pp. e236887
Author(s):  
Menaka Mahendran ◽  
Daniel Urbine
Keyword(s):  
Antifungal Therapy ◽  
High Mortality ◽  
Surgical Intervention ◽  
Main Pulmonary Artery ◽  
Invasive Pulmonary Aspergillosis ◽  
Chest Discomfort ◽  
Pulmonary Aspergillosis ◽  
Extensive Disease ◽  
Massive Haemoptysis ◽  
History Of

A 47-year-old Caucasian man on long-standing antifungal therapy for chronic necrotising aspergillosis and a history of recurrent pseudomonas pneumonias presented to the outpatient pulmonary clinic with dyspnoea and chest discomfort for 3 days. A CT angiography of the chest demonstrated angioinvasion from the previously noted left upper lobe cavitary lesion into the left main pulmonary artery, along with new consolidating lesions. Due to the high risk for massive haemoptysis, he was evaluated by thoracic surgery and underwent a successful left pneumonectomy. As invasive pulmonary aspergillosis is associated with high mortality, surgical intervention should always be considered, especially in those who develop extensive disease, despite being on aggressive antifungal therapy. Though minimally described in literature, invasive pulmonary pseudomonas also carries a high mortality risk. In our patient, cultures from the resected lung only demonstrated Pseudomonas aeruginosa.

Risks Of Ventilator-Associated Pneumonia And Invasive Pulmonary Aspergillosis In Patients With Viral Acute Respiratory Distress Syndrome Related or Not To Coronavirus 19 Disease

2020 ◽  
Author(s):  
Keyvan Razazi ◽  
Romain ARRESTIER ◽  
Anne-Fleur Haudebourg ◽  
Brice Benelli ◽  
Guillaume Carteaux ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Invasive Aspergillosis ◽  
Distress Syndrome ◽  
Invasive Pulmonary Aspergillosis ◽  
Resistant Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Retrospective Case ◽  
Pulmonary Aspergillosis

Abstract Background The goal of this study was to assess risk factors of ventilator-associated pneumonia (VAP) and invasive pulmonary aspergillosis in patients with SARS-CoV-2 infection.Methods. We conducted a monocenter retrospective study comparing the prevalence of VAP and invasive aspergillosis between patients with COVID-19 related acute respiratory distress syndrome (C-ARDS) and those with non-SARS-CoV-2 viral ARDS (NC-ARDS).Results. We assessed 90 C-ARDS and 82 NC-ARDS patients, who were mechanically ventilated for more than 48 hours. At ICU admission, there were significantly fewer bacterial coinfections documented in C-ARDS than in NC-ARDS: 14 (16%) vs 38 (48%), p<0.01. Conversely, significantly more patients developed at least one VAP episode in C-ARDS as compared with NC-ARDS : 58 (64%) vs. 36 (44%), p=0.007. The probability of VAP was significantly higher in C-ARDS after adjusting on death and ventilator weaning [sub-hazard ratio = 1.72 (1.14-2.52), p<0.01].The prevalence of multi-drug resistant bacteria (MDR) related VAP was significantly higher in C-ARDS than in NC-ARDS: 21 (23%) vs. 9 (11%), p=0.03. Carbapenem was more used in C-ARDS than in NC-ARDS: 48 (53%), vs 21 (26%), p<0.01. According to AspICU algorithm, there were fewer cases of putative aspergillosis in C-ARDS than in NC-ARDS [2 (2%) vs. 12 (15%), p=0.003], but there was no difference in Aspergillus colonization.Conclusions. In this retrospective case-control study, we evidenced a higher prevalence of VAP and MDR-VAP in C-ARDS than in NC-ARDS, and a lower risk for invasive aspergillosis in the former group.

scholarly journals Efficacy of Ambruticin Analogs in a Murine Model of Invasive Pulmonary Aspergillosis

2006 ◽  
Vol 50 (10) ◽  
pp. 3464-3466 ◽  
Author(s):  
Lisa Y. Chiang ◽  
Daniele E. Ejzykowicz ◽  
Zong-Qiang Tian ◽  
Leonard Katz ◽  
Scott G. Filler
Keyword(s):  
Antifungal Activity ◽  
Mouse Model ◽  
Invasive Aspergillosis ◽  
Murine Model ◽  
Antifungal Agents ◽  
Invasive Pulmonary Aspergillosis ◽  
Vehicle Control ◽  
Pulmonary Aspergillosis

ABSTRACT Ambruticins are a family of polyketides. The antifungal activity of an ambruticin, KOSN-2079, was tested in the mouse model of invasive aspergillosis. KOSN-2079 significantly reduced pulmonary fungal burdens and improved survival over that with the vehicle control. These results support the continued development of ambruticins as antifungal agents.

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