scholarly journals Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-216179
Author(s):  
Anaïs Hérivaux ◽  
Jesse R Willis ◽  
Toine Mercier ◽  
Katrien Lagrou ◽  
Samuel M Gonçalves ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Alpha Diversity ◽  
Immunocompromised Patients ◽  
Pulmonary Aspergillosis ◽  
Cytokines And Chemokines ◽  
Lung Microbiome ◽  
Patients At Risk ◽  
Observational Cohort ◽  
Clinical Variation

RationaleRecent studies have revealed that the lung microbiota of critically ill patients is altered and predicts clinical outcomes. The incidence of invasive fungal infections, namely, invasive pulmonary aspergillosis (IPA), in immunocompromised patients is increasing, but the clinical significance of variations in lung bacterial communities is unknown.ObjectivesTo define the contribution of the lung microbiota to the development and course of IPA.Methods and measurementsWe performed an observational cohort study to characterise the lung microbiota in 104 immunocompromised patients using bacterial 16S ribosomal RNA gene sequencing on bronchoalveolar lavage samples sampled on clinical suspicion of infection. Associations between lung dysbiosis in IPA and pulmonary immunity were evaluated by quantifying alveolar cytokines and chemokines and immune cells. The contribution of microbial signatures to patient outcome was assessed by estimating overall survival.Main resultsPatients diagnosed with IPA displayed a decreased alpha diversity, driven by a markedly increased abundance of the Staphylococcus, Escherichia, Paraclostridium and Finegoldia genera and a decreased proportion of the Prevotella and Veillonella genera. The overall composition of the lung microbiome was influenced by the neutrophil counts and associated with differential levels of alveolar cytokines. Importantly, the degree of bacterial diversity at the onset of IPA predicted the survival of infected patients.ConclusionsOur results reveal the lung microbiota as an understudied source of clinical variation in patients at risk of IPA and highlight its potential as a diagnostic and therapeutic target in the context of respiratory fungal diseases.

scholarly journals Cytokine and Chemokine Responses in Invasive Aspergillosis following Hematopoietic Stem Cell Transplantation: Past Evidence for Future Therapy of Aspergillosis

2021 ◽  
Vol 7 (9) ◽  
pp. 753
Author(s):  
Patcharin Thammasit ◽  
Jirapas Sripetchwandee ◽  
Joshua D. Nosanchuk ◽  
Siriporn C. Chattipakorn ◽  
Nipon Chattipakorn ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Hematopoietic Stem ◽  
Cytokines And Chemokines

Invasive pulmonary aspergillosis is a frequent complication in immunocompromised individuals, and it continues to be an important cause of mortality in patients undergoing hematopoietic stem cell transplantation. In addition to antifungal therapy used for mycoses, immune-modulatory molecules such as cytokines and chemokines can modify the host immune response and exhibit a promising form of antimicrobial therapeutics to combat invasive fungal diseases. Cytokine and chemokine profiles may also be applied as biomarkers during fungal infections and clinical research has demonstrated different activation patterns of cytokines in invasive mycoses such as aspergillosis. In this review, we summarize different aspects of cytokines that have been described to date and provide possible future directions in research on invasive pulmonary aspergillosis following hematopoietic stem cell transplantation. These findings suggest that cytokines and chemokines may serve as useful biomarkers to improve diagnosis and monitoring of infection.

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.

scholarly journals Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

2015 ◽  
Vol 47 (1) ◽  
pp. 45-68 ◽  
Author(s):  
David W. Denning ◽  
Jacques Cadranel ◽  
Catherine Beigelman-Aubry ◽  
Florence Ader ◽  
Arunaloke Chakrabarti ◽  
...  
Keyword(s):  
Antifungal Therapy ◽  
Clinical Guidelines ◽  
Bronchial Artery ◽  
Invasive Pulmonary Aspergillosis ◽  
Immunological Response ◽  
Surgical Excision ◽  
Immunocompromised Patients ◽  
Pulmonary Aspergillosis ◽  
Thoracic Imaging ◽  
Chronic Pulmonary Aspergillosis

Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ∼240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include:Aspergillusnodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease. Subacute invasive pulmonary aspergillosis (formerly called chronic necrotising pulmonary aspergillosis) is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. Few clinical guidelines have been previously proposed for either diagnosis or management of CPA. A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence ofAspergillusinfection (microscopy or culture from biopsy) or an immunological response toAspergillusspp. and exclusion of alternative diagnoses, all present for at least 3 months.Aspergillusantibody (precipitins) is elevated in over 90% of patients. Surgical excision of simple aspergilloma is recommended, if technically possible, and preferablyviavideo-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, arrest haemoptysis and prevent progression. Careful monitoring of azole serum concentrations, drug interactions and possible toxicities is recommended. Haemoptysis may be controlled with tranexamic acid and bronchial artery embolisation, rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. Patients with singleAspergillusnodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up.

scholarly journals A Case of Chronic Granulomatous Disease with a Necrotic Mass in the Bronchus: A Case Report and a Review of Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Ali Cheraghvandi ◽  
Majid Marjani ◽  
Saeid Fallah Tafti ◽  
Logman Cheraghvandi ◽  
Davoud Mansouri
Keyword(s):  
Case Report ◽  
Chronic Granulomatous Disease ◽  
Medical Therapy ◽  
Unusual Case ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Granulomatous Disease ◽  
Review Of Literature ◽  
Pulmonary Aspergillosis ◽  
The Right

Chronic granulomatous disease is a rare phagocytic disorder with recurrent, severe bacterial and fungal infections. We describe an unusual case of chronic granulomatous disease manifesting as an invasive pulmonary aspergillosis with an obstructive necrotic mass at the right middle bronchus. The patient was successfully treated with a bronchoscopic intervention for the removal of the obstructive mass and a medical therapy.

Fungal contamination of water and water-related surfaces in three hospital wards with immunocompromised patients at risk for invasive fungal infections

2010 ◽  
Vol 11 (2) ◽  
pp. 36-41 ◽  
Author(s):  
Julia de Castro Figueiredo Fonseca ◽  
Adel Bouakline ◽  
Jean-Pierre Claisse ◽  
Martine Feuilhade ◽  
André Baruchel ◽  
...  
Keyword(s):  
At Risk ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Immunocompromised Patients ◽  
Fungal Contamination ◽  
Patients At Risk ◽  
Hospital Wards
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