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Infectious Optic Neuropathies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Imran Rizvi, Ravindra Kumar Garg
Aspergillosis is also common in immune compromised state. Aspergillosis varies from noninvasive form to life-threatening invasive form. Optic nerve involvement occurs as a result of extension from aspergillus rhino-sinusitis. Patient presents with facial pain, orbital swelling, rhinorrhea, vision loss and restricted eye movements. Multiple cranial nerves are frequently involved. Aspergillosis can also cause dacryocystitis, periorbital cellulitis, endophthalmitis and vitritis. Definite diagnosis requires biopsy. Microscopic examination shows branching and septate hyphae.60 Management of invasive rhino orbital aspergillosis requires surgical debridement along with antifungal therapy. Voriconazole is the drug of choice.60
The Potential of Medicinal Plants as Treatments for Infections Caused by Aspergillus spp.
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Tefo K. Pule, Marco N. De Canha, Namrita Lall, Quenton Kritzinger
Aspergillosis refers to infections caused by fungi from the genus Aspergillus. Aspergillus infections are not only limited to humans, and can cause aspergillosis in birds as well (avian aspergillosis) (Suleiman et al., 2012). However, this chapter will focus only on aspergillosis affecting humans. The most common type of aspergillosis is known as pulmonary aspergillosis, which affects the respiratory pathway of the host. Other types include cutaneous aspergillosis, which affects the skin, and otomycosis, which affects the ears (Centers for Disease Control and Prevention, 2014). The three types of Aspergillus infections (pulmonary [with subtypes], cutaneous and otomycosis) are discussed in detail based on reports that have implicated Aspergillus spp. as the causative pathogens, confirmed by the isolation and identification of these fungi from afflicted individuals.
The Fungi
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
The genus Aspergillus includes many species, but most disease in humans is caused by Aspergillus fumigatus. The aspergilli are common saprophytes which produce hyphal growth both in the environment, where they are ubiquitous, and in the host. Despite daily exposure to aspergillus conidia, invasive aspergillosis occurs only in the severely compromised host. Either a lack of PMNs or improperly functioning PMNs predispose the host to life-threatening aspergillosis. Neutropenia is in fact the greatest single risk factor for invasive aspergillosis and occurs primarily in patients undergoing immunosuppressive chemotherapy or radiation therapy for cancers or transplants. Antifungal therapy is attempted in these cases, but the prognosis is generally poor due to the underlying condition of the host.
Early diagnosis of aspergillosis in asthmatic and rheumatoid arthritis patients by Aspergillus galactomannan antigen assay: a case-control study in Karbala providence
Published in Journal of Asthma, 2022
Ali Abdul Hussein S. Al-Janabi, Roaa Noori Ali
From the results of this study, aspergillosis as indicated by GM was found higher among apparently healthy male individuals than in other patient groups. This could be illustrated by two possible explanations; the first is that individuals had an early development of aspergillosis without a specific symptom and the second is that a GM test may give a false-positive result. In general, individuals with a good immune system are often under the risk of aspergillosis. Patients with either RA or RA and asthma are more susceptible to acquired aspergillosis, especially aspergilloma or fungal ball (13). Aspergillus fumigatus was diagnosed as a causative agent of pleural aspergillosis in healthy individuals without any predisposing factors or lung pathology (14). This was also noticed with invasive aspergillosis caused by Aspergillus niger which was diagnosed in immunocompetent individuals (13). Aspergilloma is usually encouraged to develop when the inhaled fungal spore grows in lung cavities resulting from previous diseases such as TB and sarcoidosis (2). Thus, antibodies against such undetectable infections give a positive result in healthy individuals. Otherwise, ELISA for GM is more specific to detect early invasive aspergillosis with 90% sensitivity and 84% specificity (15). On the other hand, a false-positive result for the GM serological tests was recorded by many studies. These results may be associated with the presence of fungal infections with other than Aspergillus types or may relate to treatment with antibiotics (16). About 12% of invasive aspergillosis gave a false-positive for GM by ELISA (17).
Invasive Aspergillus infection of middle ear in a patient treated with secukinumab, methotrexate, and corticosteroids for psoriasis and psoriatic arthritis
Published in Journal of Dermatological Treatment, 2022
Filip Rob, Lukáš Školoudík, Viktor Chrobok, Jana Dědková, Petra Kašparová, Lucie Podrazilová
Invasive aspergillosis is an opportunistic infection most commonly seen in patients with prolonged neutropenia (e.g. immunosuppressive patients because of solid or bone marrow transplantation). Modern biologic therapies, including TNF-alpha and IL-17 inhibitors, also interfere with neutrophil function. Only sporadic cases of invasive aspergillosis have been reported with infliximab and etanercept treatment in patients with inflammatory bowel disease and rheumatoid arthritis (5). Invasive Aspergillus infection has not been reported with secukinumab or ixekizumab therapy, even in long-term safety studies lasting 5 years (3,6). With our patient, the development of this opportunistic infection could be facilitated by the current therapy with methotrexate. Like treatment with methotrexate (usually a high dose), cases of aspergillosis in transplant patients have been rarely described. If aspergillosis is suspected, an X-ray or CT scan (according to the localization) should be performed. These examinations reveal a fungal mass (aspergilloma) and characteristic signs of invasive aspergillosis. Non-culture-based tests (galactomannan or β(1,3)-glucan test) can also help diagnose the disease. A sputum examination (culture, PCR) can be used in bronchopulmonary aspergillosis, but tissue biopsy is usually necessary to confirm the diagnosis (7).
Fungal abscess after intra-orbital steroid injection: a case report
Published in Orbit, 2022
Mythri K. Rao, Md. Shahid Alam, Ram Gopalakrishnan, Bipasha Mukherjee
Aspergillus species is a ubiquitous saprophytic mold of class Ascomycetes widely distributed in the environment, particularly found in soil, and decaying vegetation.9 Aspergillosis is a fungal infection caused by fungi of the genus Aspergillus. Aspergillus fumigatus, flavus, and niger are responsible for most infections.10 Infection with A. fumigatus is more common in immunocompromised hosts, while A. flavus affects immunocompetent hosts.11 Invasive aspergillosis is well documented in immunocompromised patients, with the primary risk factors being neutrophil defects and corticosteroid use.12 While A. fumigatus is the most common species implicated in invasive fungal infections, A. flavus has been isolated more often from sino-orbital aspergillosis or Aspergillus eye infections in developing countries.13,14A. flavus is more virulent than A. fumigatus in terms of inoculum required.15 Developing countries have witnessed a surge in A. flavus infection, possibly due to greater environmental contamination of A. flavus. Hence, this species is reported as the most common cause of invasive fungal disease in India.14,16