Pulmonary Aspergillus Overlap Syndromes.

Abstract:

BACKGROUND:Broadly, there are three main categories in pulmonary aspergillosis: chronic forms of aspergillosis; allergic bronchopulmonary aspergillosis; and invasive aspergillosis (IPA). IPA has been further subdivided into angioinvasive and airway-invasive aspergillosis. Aspergillus overlap syndromes is defined as the occurrence of more than one form aspergillus disease in a single individual. OBJECTIVES:To help clinicians correctly deal with AOS. METHODS:Retrospectively study the clinical findings of nine patients presenting with AOS. RESULTS:Four cases were diagnosed as angioinvasive aspergillosis complicated with ABPA, three cases as IPA overlap aspergilloma, and two cases as ABPA with AWIA. All the patients presented with cough and expectoration. In three patients with IPA overlap aspergilloma, two had hemoptysis, two had wheezing and fever. All of patients with IPA overlap ABPA had wheezing, dyspnea, and fever, three had sputum plugs, two had hemoptysis, and five patients had mucopurulent discharge and rhonchi in auscultation. Their total IgE ranged from 129 to 2124 IU/ml (676.5 ± 557.33 IU/ml). Fungal culture in sputum showed A. Fumigatus in three patients. All the six patients with IPA overlap ABPA applied steroid therapy and antifungal therapy. Three of them received two or more antifungal drugs successively, and three received combinational therapy. All the patients improved except one diagnosed ABPA overlap IPA. CONCLUSIONS:Clinical manifestation of AOS is not typical. Poor first-line therapeutic effects and complicated diagnosis criteria require clinicians to be aware of AOS when facing patients with aspergillosis.

journal_name

Mycopathologia

journal_title

Mycopathologia

authors

Li L,Jiang Z,Shao C

doi

10.1007/s11046-017-0212-y

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

431-438

issue

2

eissn

0301-486X

issn

1573-0832

pii

10.1007/s11046-017-0212-y

journal_volume

183

pub_type

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