Itraconazole
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Itraconazole remains a treatment option for patients with chronic pulmonary aspergillosis. In a randomized controlled trial of 31 patients with chronic cavitary pulmonary aspergillosis (CCPA), itraconazole treatment was associated with an improved clinical response when compared to supportive therapy alone (35% vs. 7%) (Agarwal et al., 2013). Radiographic response was also improved in the itraconazole treated group (23% vs. 0%). A study examining the health of patients with chronic pulmonary aspergillosis found approximately half of patients receiving antifungal treatment had improved health status by a standardized St George’s Respiratory Questionnaire (Al-Shair et al., 2013). This study included patients receiving a variety of antifungal agents and improved response rates were noted for voriconazole and posaconazole over itraconazole. Itraconazole has not been directly compared to other mold-active azoles for treatment of chronic pulmonary aspergillosis.
The Potential of Medicinal Plants as Treatments for Infections Caused by Aspergillus spp.
Namrita Lall in Medicinal Plants for Cosmetics, Health and Diseases, 2022
Chronic pulmonary aspergillosis is a lung disease within the scope of IA. It refers to long-term infection of aspergillosis associated with cavitary lung disease, chronic respiratory symptoms and Aspergillus serum antibody precipitation (Thompson and Patterson, 2008). Once the conidia successfully evade the immune system of immunocompromised individuals, they germinate and form hyphal networks in the lung’s interior surface cavity, consequently damaging the surrounding parenchyma tissue. In some cases, the growth may progress into the formation of a fungal ball also known as an aspergilloma (Figure 19.2) (Maghrabi and Denning, 2017).
Invasive Pulmonary Aspergillosis
Firza Alexander Gronthoud in Practical Clinical Microbiology and Infectious Diseases, 2020
Inhalation of Aspergillus spores is a common occurrence and harmless for healthy humans. In immunocompromised individuals, inhaled spores are not cleared by the immune system and cause invasive pulmonary aspergillosis. Aspergillus can also exacerbate underlying lung conditions, cause chronic pulmonary infection without angioinvasion (chronic pulmonary aspergillosis) or severe allergic reactions (allergic bronchopulmonary aspergillosis). This chapter discusses invasive pulmonary aspergillosis (IPA).
Advances in predicting patient survival in pulmonary sarcoidosis
Published in Expert Opinion on Orphan Drugs, 2021
Gamze Kirkil, Elyse Lower, Robert Baughman
Sarcoidosis patients with chronic inflammation can develop pulmonary cavities with resultant fungal infections including aspergillus. Aspergillus-related lung disease occurs in up to 1–2% of patients and is associated with poor outcomes (24,75, 102, 103). Chronic pulmonary aspergillosis is a diagnosis based on the presence of: 1) at least one pulmonary cavity on thoracic imaging with or without one or more fungal balls in a cavity, and 2) positive blood anti-Aspergillus immunoglobulin G antibodies or 3) cultures/histology implicating Aspergillus spp. or showing hyphae compatible with Aspergillus (108). The presence of cavitary lesions alone in a sarcoidosis patient is not sufficient to make the diagnosis of chronic pulmonary aspergillosis, since fibrotic sarcoidosis can lead to fibrocystic disease (73).
Clinical characteristics of allergic bronchopulmonary aspergillosis in patients with and without bronchiectasis
Published in Journal of Asthma, 2022
Sijiao Wang, Jun Zhang, Cuiping Zhang, Changzhou Shao
A total of 93 patients hospitalized due to acute wheezing dyspnea, hemoptysis, asthma exacerbation, discovery of unknown pulmonary shadows, and reexamination were enrolled, including 74 cases with ABPA-CB and 19 cases with ABPA-S. As shown in Table 1, the mean age at onset was 52.4-year old, and no significant differences were observed between the two groups in age, sex proportion, and smoking history. Asthma was the most common pulmonary comorbidity (36.6%), with a median history of 30 (IQR 13–42.5) years. Seven patients (7.5%) had chronic pulmonary aspergillosis (CPA). The symptoms in the ABPA-CB and ABPA-S groups showed little difference except for hemoptysis (p = 0.019). Of 46 patients (49.5%) with lung function tests, obstructive ventilation dysfunction was found in 21 patients, and mixed ventilation dysfunction in 16. Initially, 39 patients (41.9%) received systemic corticosteroid treatment, and 54 patients (58.1%) were administered both antifungal agents and systemic corticosteroids.
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
RA is an autoimmune disease with inflammatory features that leads to joint destruction and disability (6,18). It is thought to develop under the effects of genetic and/or environmental factors (19). Patients with RA can be at risk to get infections due to treatment with many immunosuppressive drugs (3). In a rare case, A. fumigatus was found to cause invasive aspergillosis in an arthritis patient (20). Aspergillosis was diagnosed in many patients with RA in this study, especially among females. The susceptibility of females to RA is clearly observed during menopause, when ovarian functions are declining (21). Many predisposing factors can play a role in the development of aspergillosis in RA patients. Treatment of patients with RA by immunosuppressive drugs such as glucocorticoids, DMARDs, or TNFα inhibitors is considered the most important predisposing factor for the development of aspergillosis (3,22). However, aspergillosis in RA patients was mentioned in a few studies. Aspergillus nodules were diagnosed in patients with clinical features of RA (23). Males with RA who are treated with immunosuppressive drugs or under surgery are also at risk to have aspergillosis (24). Chronic pulmonary aspergillosis in the form of multiple nodules was diagnosed in patients with RA (23).
Related Knowledge Centers
- Allergic Bronchopulmonary Aspergillosis
- Aspergilloma
- Aspergillus Fumigatus
- Asthma
- Lung Cancer
- Tuberculosis
- Acute
- Immunodeficiency
- Presentation
- Radiology