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[Complex respiratory aspergillosis: diagnostic and therapeuthic difficulties]
M Marcq1, P Germaud, L Cellerin
1Service de Pneumologie, Hôpital G. & R. Laennec, CHU de Nantes, France.
Revue Des Maladies Respiratoires
|March 16, 2005
Summary
Rare cases of respiratory aspergillosis involve multiple forms, complicating diagnosis and treatment. Combined allergic bronchopulmonary aspergillosis (ABPA) and other fungal infections require careful management, often including systemic antifungal therapy.
Area of Science:
- Pulmonology
- Mycology
- Infectious Diseases
Background:
- Respiratory aspergillosis can present with diverse physiopathologic mechanisms, occasionally coexisting within a single patient.
- Co-infection with multiple forms of pulmonary aspergillosis is uncommon but presents significant clinical challenges.
Observation:
- This study reviews three cases of concurrent Allergic Bronchopulmonary Aspergillosis (ABPA) with other forms of aspergillosis, including aspergilloma and chronic necrotizing pulmonary aspergillosis.
- A comprehensive literature review was conducted to understand these complex associations.
Findings:
- The coexistence of different aspergillosis forms leads to substantial diagnostic and therapeutic difficulties.
- Corticosteroid therapy for ABPA may escalate the risk of severe invasive fungal infections in these patients.
Implications:
- Concurrent aspergillosis necessitates a high index of suspicion for accurate diagnosis.
- Systemic antifungal therapy is indicated for patients with combined forms of respiratory aspergillosis.
- Management strategies must address both the allergic and invasive components of the disease.