Chronic aspergillus infections of the respiratory tract: diagnosis, management and antifungal resistance.
OBJECTIVE
Chronic pulmonary aspergillosis (CPA) is a relatively rare, slowly progressive pulmonary syndrome due to Aspergillus spp. that requires specific knowledge in terms of disease entity, diagnosis, management and azole resistance. This review focuses on the recent understanding of CPA entity and the emergence of azole resistance in CPA.


RESULTS
Due to complexities related to patients' background and limited pathological evidence, the disease entity of CPA was incomprehensive and numerous names were previously used. The disease entities and nomenclature of subtypes of CPA have recently been proposed, though previous literature had grouped several different forms of CPA together. Recent advances in the methodology of susceptibility testing have indicated increasing azole resistance in Aspergillus spp. CPA is potentially involved in producing azole resistance and associated with poor response to azoles.


CONCLUSIONS
As there are few publications regarding CPA, there are still many unanswered questions. However, updating of disease entity will promote the clinical and basic research in this field. Moreover, the emergence of antifungal drug resistance of Aspergillus is becoming a major concern. Thus, more evidence and research regarding drug resistance are required to improve the outcome of CPA.
Izumikawa
Koichi
K
Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. koizumik@nagasaki-u.ac.jp
Takazono
Takahiro
T
Kohno
Shigeru
S
D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001230:Aspergillus / Q000187:drug effects* / Q000235:genetics / Q000502:physiology; D025141:Drug Resistance, Fungal / Q000235:genetics; D006801:Humans; D055732:Pulmonary Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*
D000935:Antifungal Agents