scholarly journals Fungus ball in HIV-infected patients

2009 ◽  
Vol 51 (6) ◽  
pp. 345-348 ◽  
Author(s):  
Luciana Silva Guazzelli ◽  
Gisela Unis ◽  
Melissa Orzechowski Xavier ◽  
Cecília Bittencourt Severo ◽  
Pedro Dornelles Picon ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Lung Disease ◽  
Radiographic Feature ◽  
Fungus Ball ◽  
Fungal Ball

Aspergillus is a phagocyte opportunistic fungus that causes aspergillosis, an unusual disease in patients with AIDS. Six cases of fungal ball in patients with AIDS are reported here. In this group, all patients had hemoptysis and tuberculosis as the underlying lung disease. The diagnosis of pulmonary fungus ball was based on the clinical and radiographic feature, combined with serological and mycological evidence of Aspergillus fumigatus.

scholarly journals Aspergilloma formation in cavitary sarcoidosis

2009 ◽  
Vol 35 (5) ◽  
pp. 480-483 ◽  
Author(s):  
Chandramani Panjabi ◽  
Sandeep Sahay ◽  
Ashok Shah
Keyword(s):  
Aspergillus Fumigatus ◽  
Lung Disease ◽  
Female Patient ◽  
Skin Test ◽  
Fiberoptic Bronchoscopy ◽  
Pulmonary Sarcoidosis ◽  
Dramatic Improvement ◽  
Skin Test Reactivity ◽  
Noncaseating Granuloma

Pulmonary cavitation is rather uncommon in patients with sarcoidosis, and aspergilloma is even more uncommon in such cases. Here, we present the case of a 63-year-old female patient with cavitary lung disease who had been under treatment for TB for 9 months. A diagnosis of pulmonary sarcoidosis was established based on the fiberoptic bronchoscopy finding of noncaseating granuloma. Treatment with corticosteroids led to a dramatic improvement in symptoms. While under treatment for sarcoidosis, the patient developed an aspergilloma. She presented immediate skin test reactivity to Aspergillus fumigatus, as well as positivity for A. fumigatus serum precipitins. This is the first reported case of aspergilloma formation in a patient with cavitary sarcoidosis in India.

scholarly journals Unusual Location of a Fungus Ball: The Concha Bullosa, a Review of the Literature

2021 ◽  
Vol 12 ◽  
pp. 215265672110361
Author(s):  
Walid Bijou ◽  
Bushra Abdulhakeem ◽  
Karim Choukry ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Demographic Data ◽  
Fungus Ball ◽  
Concha Bullosa ◽  
Review Of The Literature ◽  
Gender Ratio ◽  
Fungal Ball ◽  
The Mean ◽  
Rare Diagnosis ◽  
Tomography Scan

Introduction The fungal balls of the paranasal sinuses are usually seen in the maxillary and sphenoid sinuses. Although, the lesion of the concha bullosa, without sinus participation, is very uncommon. We report the case of a fungal ball of concha bullosa in an 88-year-old patient. Objective The objective of our review of literature is to investigate the epidemiological, clinical, paraclinical, and therapeutic characteristics of patients diagnosed with fungus ball in concha bullosa. Methods A case of a patient who was diagnosed with concha bullosa of a fungus ball is reported. Demographic data, clinical presentation, imaging, and treatments were recorded. Key images were obtained. A review of the literature was also performed. Results A total of 12 cases have been reported so far in the literature revealed by different symptoms. The mean age was 38.8 years and the gender ratio was ∼12 (female):1 (male). The endoscopic surgical approach was the most frequently used treatment and provides good outcomes. Neither postoperative complications nor recurrences were noted, however, there is insufficient follow-up data. Conclusion Concha bullosa fungal ball is a rare diagnosis that can be revealed by different symptoms. It should be considered in patients with and unexplained chronic facial pain. A preoperative computed tomography scan is an essential tool in making a diagnosis. Endoscopic surgery is the treatment of choice, with a low morbidity and recurrence rate.

scholarly journals Coinfection with Pseudomonas aeruginosa and Aspergillus fumigatus in cystic fibrosis

2020 ◽  
Vol 29 (158) ◽  
pp. 200011
Author(s):  
Karen Keown ◽  
Alastair Reid ◽  
John E. Moore ◽  
Clifford C. Taggart ◽  
Damian G. Downey
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Aspergillus Fumigatus ◽  
Lung Disease ◽  
Disease Progression ◽  
Expert Knowledge ◽  
Fungal Species ◽  
Interspecies Interactions ◽  
Cross Sectional ◽  
Infection And Inflammation

ObjectivesCystic fibrosis (CF) lung disease is characterised by mucus stasis, chronic infection and inflammation, causing progressive structural lung disease and eventual respiratory failure. CF airways are inhabited by an ecologically diverse polymicrobial environment with vast potential for interspecies interactions, which may be a contributing factor to disease progression. Pseudomonas aeruginosa and Aspergillus fumigatus are the most common bacterial and fungal species present in CF airways respectively and coinfection results in a worse disease phenotype.MethodsIn this review we examine existing expert knowledge of chronic co-infection with P. aeruginosa and A. fumigatus in CF patients. We summarise the mechanisms of interaction and evaluate the clinical and inflammatory impacts of this co-infection.ResultsP. aeruginosa inhibits A. fumigatus through multiple mechanisms: phenazine secretion, iron competition, quorum sensing and through diffusible small molecules. A. fumigatus reciprocates inhibition through gliotoxin release and phenotypic adaptations enabling evasion of P. aeruginosa inhibition. Volatile organic compounds secreted by P. aeruginosa stimulate A. fumigatus growth, while A. fumigatus stimulates P. aeruginosa production of cytotoxic elastase.ConclusionA complex bi-directional relationship exists between P. aeruginosa and A. fumigatus, exhibiting both mutually antagonistic and cooperative facets. Cross-sectional data indicate a worsened disease state in coinfected patients; however, robust longitudinal studies are required to derive causality and to determine whether interspecies interaction contributes to disease progression.

scholarly journals Clinical and experimental phenotype of azole-resistant Aspergillus fumigatus with a HapE splice site mutation: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuya Ito ◽  
Takahiro Takazono ◽  
Satoru Koga ◽  
Yuichiro Nakano ◽  
Nobuyuki Ashizawa ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Splice Site ◽  
Splice Site Mutation ◽  
Antifungal Treatment ◽  
Resistant Isolate ◽  
Infection Model ◽  
Low Grade ◽  
Fungus Ball ◽  
Site Mutation

Abstract Background The recent increase in cases of azole-resistant Aspergillus fumigatus (ARAf) infections is a major clinical concern owing to its treatment limitations. Patient-derived ARAf occurs after prolonged azole treatment in patients with aspergillosis and involves various cyp51A point mutations or non-cyp51A mutations. The prognosis of patients with chronic pulmonary aspergillosis (CPA) with patient-derived ARAf infection remains unclear. In this study, we reported the case of a patient with ARAf due to HapE mutation, as well as the virulence of the isolate. Case presentation A 37-year-old male was presented with productive cough and low-grade fever. The patient was diagnosed with CPA based on the chronic course, presence of a fungus ball in the upper left lobe on chest computed tomography (CT), positivity for Aspergillus-precipitating antibody and denial of other diseases. The patient underwent left upper lobe and left S6 segment resection surgery because of repeated haemoptysis during voriconazole (VRC) treatment. The patient was postoperatively treated with VRC for 6 months. Since then, the patient was followed up without antifungal treatment but relapsed 4 years later, and VRC treatment was reinitiated. Although an azole-resistant isolate was isolated after VRC treatment, the patient did not show any disease progression in either respiratory symptoms or radiological findings. The ARAf isolated from this patient showed slow growth, decreased biomass and biofilm formation in vitro, and decreased virulence in the Galleria mellonella infection model compared with its parental strain. These phenotypes could be caused by the HapE splice site mutation. Conclusions This is the first to report a case demonstrating the clinical manifestation of a CPA patient infected with ARAf with a HapE splice site mutation, which was consistent with the in vitro and in vivo attenuated virulence of the ARAf isolate. These results imply that not all the ARAf infections in immunocompetent patients require antifungal treatment. Further studies on the virulence of non-cyp51A mutations in ARAf are warranted.

scholarly journals High-Level Pan-Azole-Resistant Aspergillosis: TABLE 1

2015 ◽  
Vol 53 (7) ◽  
pp. 2343-2345 ◽  
Author(s):  
Jakko van Ingen ◽  
Henrich A. L. van der Lee ◽  
Antonius J. M. M. Rijs ◽  
Eveline Snelders ◽  
Willem J. G. Melchers ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Lung Disease ◽  
Gene Mutation ◽  
Chronic Lung Disease ◽  
Azole Resistance ◽  
Content Type ◽  
High Level ◽  
New Strategies ◽  
Progressive Resistance

High-level pan-azole-resistantAspergillus fumigatuswas recovered from four patients with chronic lung disease. In one patient, the development of progressive resistance followed long-term azole therapy and switching between antifungal azoles. The high-level pan-azole-resistant phenotypes were not associated with a specificcyp51Agene mutation. New strategies that avoid the development of progressive azole resistance are needed.

scholarly journals Fungus ball of the paranasal sinuses: Report of two cases and literature review

2012 ◽  
Vol 16 (02) ◽  
pp. 286-290 ◽  
Author(s):  
Guilherme Bosi ◽  
Gustavo de Braga ◽  
Tobias de Almeida ◽  
Adriana de Carli
Keyword(s):  
Computed Tomography ◽  
Physical Examination ◽  
Endodontic Treatment ◽  
Sinus Surgery ◽  
Invasive Infection ◽  
Fungus Ball ◽  
Fungal Ball ◽  
Treatment Standard ◽  
The Feminine ◽  
History Of

Summary Introduction: Fungal ball of the sinuses is a not invasive infection that if characterizes for its chronicity, being the majority related with previous endodontic treatment. Affect mainly the breasts to maxillary; even so all the breasts can be involved. The main etiological agent is the Aspergillus spp. The computed tomography, had to characteristic the radiological presentations, suggests the diagnosis that is carried through definitively through histopathological analyses. The treatment standard-gold is the sinus surgery with average meatal antrostomy. Objective: Reporting two cases of fungal ball of the sinuses and to stand out important aspects of this pathology. Story of the Cases: Case 1) Patient of the feminine sex, 78 years old, presented itself with complaints of face pain has 6 months and previous history of endodontic treatment. To the physical examination it was evidenced purulent secretion presence in left average meatus. Ray X presented complete veiling of the breasts to maxillary left, while the computed tomography showed injury calcified in this place. Sinusotomy was become fulfilled that evolved well. Case 2) Patient of the feminine sex, 70 years old, looked attendance for history of sinusitis of repetition. To the physical examination no particularity was not perceived. The computed tomography, as well as the magnetic resonance, detected thickening of the mucous wall of the breasts to maxillary left, beyond a calcified mass. It was become fulfilled same sequence of treatment and the patient also evolved well. Final Considerations: The fungal infection must be considered in the patients who if present with chronic sinusitis, that they do not answer to the antibiotic use and that they possess history of endodontic manipulation.

scholarly journals Aspergillus fumigatus fungus ball in hospitalized patients with chronic pulmonary disease: usefulness of double immunodiffusion test as a screening procedure

1988 ◽  
Vol 83 (3) ◽  
pp. 357-360 ◽  
Author(s):  
M. F. Ferreira-da-Cruz ◽  
B. Wanke ◽  
C. Pirmez ◽  
B. Galvão-Castro
Keyword(s):  
Aspergillus Fumigatus ◽  
Clinical History ◽  
Pathological Examination ◽  
Fungus Ball ◽  
X Rays ◽  
Double Immunodiffusion ◽  
Positive Serology ◽  
Radiographic Findings ◽  
Chest Disease ◽  
Considerable Problem

Double immunodiffusion (DID) was used as a screening test for the diagnosis of aspergillosis. Three hundred and fifty patients were tested, all of them referred from a specialized chest disease hospital and without a definitive etiological diagnosis. When DID was positive addtional information such as clinical history and radiographic findings were requested and also surgical specimens were obtained whenever possible. Specific precipitin hamds for Aspergillus fumigatus antigen were found in 29 (8.3%) of 350 patients sera. Nineteen (65.5%) of the 29 patients with positive serology were recognized as having a fungus ball by X-rays signs in 17 or by pathological examination in 2 or by both in 8 patients. This two-year prospective study has shown that pulmonary aspergillos is a considerable problem among patiens admitted to a Chest Diseases Hospital, especially in those with pulmonary cavities or bronchiectasis.

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