FN: Pulmonary Aspergillus Infections Flashcards Preview

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Flashcards in FN: Pulmonary Aspergillus Infections Deck (15):
1

Diseases associated

1. Asthma: T1HS reaction to spores 2. ABPA
3. Aspergilloma (mycetoma)
4. Invasive aspergillosis
5. Extrinsic allergic alveolitis

2

Allergic Boncopulmonary aspergillosis

􏰀 T1 and T3 HS reaction to Aspergillus fumigatus
􏰀 Bronchoconstriction → bronchiectasis

3

Allergic Boncopulmonary aspergillosis Symptoms

Wheeze
Productive cough Dyspnoea

4

Allergic Boncopulmonary aspergillosis Ix

CXR: bronchiectasis
Aspergillus in sputum (black on silver stain) Aspergillus skin test or IgE RAST
+ve se precipitins
↑ IgE and ↑ eosinophils

5

Allergic Boncopulmonary aspergillosis Rx

Pred 40mg/d + itraconazole for acute attacks
Pred maintenance 5-10mg/d
Bronchodilators for asthma

6

Aspergiolloma (mycetoma)

􏰀 Fungus ball within a pre-existing cavity 􏰁 e.g. TB or sarcoid

7

Aspergiolloma (mycetoma) features

􏰀 Usually asympto
􏰀 Can → haemoptysis (may be severe)
􏰀 Lethargy, ↓wt.

8

Aspergiolloma (mycetoma) Ix

􏰀 CXR: round opacity w/i a cavity, usually apical
􏰀 Sputum culture
􏰀 +ve se precipitins
􏰀 Aspergillus skin test / RAST

9

Aspergiolloma (mycetoma) Rx

􏰀 Consider excision for solitary lesions / severe haemoptysis

10

Invasive Aspergillosis

􏰀 Aflatoxins → liver cirrhosis and HCC (especially A. flavus)

11

RF

􏰀 Immunocompromise: HIV, leukaemia, Wegener’s 􏰀 Post-broad spectrum Abx

12

Ix

􏰀 CXR: consolidation, abscess 􏰀 Sputum MCS
􏰀 BAL
􏰀 +ve se precipitins
􏰀 Serial galactomannan

13

Rx

􏰀 Voriconazole (better cf amphotericin)

14

Prog

􏰀 30% mortality

15

Exrinsic Allergic Alveolitis

􏰀
Sensitivity to Aspergillus clavatus → Malt worker’s lung

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