[Bronchopulmonary aspergillosis (author's transl)].
Bronchopulmonary infections with Aspergillus give rise to three different pathological entities. Allergic bronchopulmonary aspergillosis, found in patients with an atopic predisposition, is marked by dyspnea of the asthmatic type associated with labile radiologically detectable infiltrates, blood hypereosinophilia, enhanced total IgE levels, specific IgG fractions, and positive immediate reactions to skin tests. The long-term risk is the development of proximal bronchiectasis. Dosage and duration of corticotherapy are function of eosinophilia and total IgE levels. Pathogenicity is similar to that of extrinsic allergic alveolitis, probably involving disturbances in immune complexes from a type I reaction. Intracavital pulmonary aspergillosis involves mycotic development within a cavity or a complicating parenchymatous lesion. Severe hemoptysis may occur. Medical treatment is ineffective, and radical surgery is necessary in patients able to support operative procedures, which vary as a function of the condition of the patient. Diffuse aspergillosis occurs in immunodeficient patients, usually during the acute phase of chemotherapy induction. Spread of the disease is either from the upper respiratory tract or through the blood as septicemia. A nosocomial origin is frequent. Diagnosis depends more on the presence of hyphae in tissue biopsy specimens than cultures or serological tests which are too unreliable. Treatment is with amphotericin B preferably associated with 5 fluorocytosin.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000666:Amphotericin B / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007428:Intradermal Tests; D008176:Lung Volume Measurements; D010995:Pleural Diseases / Q000175:diagnosis
D000305:Adrenal Cortex Hormones; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007073:Immunoglobulin E; D000666:Amphotericin B
Aspergilloses bronchopulmonaires.