Infectious Optic Neuropathies
Vivek Lal in A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
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
Aspergillosis and Mucormycosis
Rebecca A. Cox in Immunology of the Fungal Diseases, 2020
Diagnostic tests have focused on developing assays to detect either antibody to Aspergillus antigens99,101-105 or the actual antigens themselves.106–109 Since patients with invasive aspergillosis usually have an altered immune response, seroconversion may be delayed or may not occur at all. Serum precipitins as determined by counterimmunoelectrophoresis, enzyme-linked immunoabsorbant assay, and passive hemagglutination are positive in 70 to 80% of patients with invasive pulmonary aspergillosis.99 Advocates of these procedures believe that an early and accurate diagnosis of invasive aspergillosis can be accomplished by monitoring with immunodiffusion, counterimmunoelectrophoresis, and other tests for demonstrating lines of identity, critical titers, and seroconversion and/or titer or band changes.
Pulmonary complications of solid-organ transplantation
Philippe Camus, Edward C Rosenow in Drug-induced and Iatrogenic Respiratory Disease, 2010
Diagnosis of invasive aspergillosis can be problematic. Aspergillus is cultured from sputum in only 8–34 per cent and from BAL fluid in 45–62 per cent of patients with invasive disease.29 Conversely, 28–55 per cent of organ transplant recipients demonstrate airway colonization in the absence of invasive disease, with the highest rates of airway colonization seen following lung transplantation.30,31 In a patient with compatible clinical and radiographic features and/or demonstration of Aspergillus in respiratory secretions by culture or cytology, the clinician must exercise judgement in deciding whether to initiate an empirical trial of antifungal therapy or pursue more definitive proof by means of transthoracic needle biopsy or surgical lung biopsy.
Primary intestinal aspergillosis resulting in acute intestinal volvulus after autologous stem cell transplantation in a patient with relapsed non-Hodgkin lymphoma: report on a rare infectious complication and a review of the literature
Published in Acta Clinica Belgica, 2019
Soetkin Kennes, Dirk Van de Putte, Jo Van Dorpe, Vanessa Van Hende, Tessa Kerre, Philip Vlummens
The incidence of invasive aspergillosis in autologous SCT ranges from 2% to 6% (mean 4,8%) with a very high mortality (78–92%) [1]. The most recent published mortality rates in autologous SCT patients do however date from 15 years ago [1]. As mortality rates, associated with invasive aspergillosis, have declined over the past decade in haematology patients in general, prognosis in autologous SCT patients could also already be improved due to better supportive care and antifungal treatment [2,3]. Unfortunately, no up-to-date data concerning this patient population has been published recently. Invasive aspergillosis is most commonly seen in the respiratory tract and when present in the gastrointestinal tract, it is mostly in the context of disseminated disease. Besides inhalation, aspergillus spores can also be ingested, although primary intestinal aspergillosis is rare and the incidence is estimated around 1% of fungal infections. It may be underreported because of the difficult diagnosis which can sometimes only be made by autopsy, this presumptive underestimation is supported by the higher number of cases found in autopsy series [4,5].
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
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).
Related Knowledge Centers
- Asthma
- Fungal Infection
- Respiratory Disease
- Cystic Fibrosis
- Corticosteroid
- Tuberculosis
- Cancer
- Immunodeficiency
- Hematopoietic Stem Cell Transplantation
- Organ Transplantation