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Aspergillus bronchitis in cystic fibrosis
David Shoseyov1, Keith G Brownlee, Steven P Conway
1Department of Pediatrics and CF Center, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Chest
|July 15, 2006
Summary
Aspergillus fumigatus in cystic fibrosis (CF) patients can cause respiratory issues beyond allergic bronchopulmonary aspergillosis (ABPA). Antifungal treatment improved patients not responding to antibiotics, suggesting A fumigatus as a direct pathogen.
Area of Science:
- Medical Mycology
- Pulmonology
- Infectious Diseases
Background:
- Aspergillus fumigatus is a common fungus found in cystic fibrosis (CF) patients.
- Allergic bronchopulmonary aspergillosis (ABPA) is a known complication of A fumigatus in CF.
- Diagnostic criteria for ABPA exist but may not encompass all A fumigatus-related respiratory issues.
Observation:
- Six CF patients experienced respiratory decline unresponsive to antibiotics.
- These patients had A fumigatus in sputum cultures.
- They did not meet the diagnostic criteria for ABPA.
Findings:
- Treatment with antifungal agents led to clinical improvement in these patients.
- This suggests A fumigatus can directly cause respiratory exacerbations in CF.
- The study highlights a potential role for antifungals in CF patients with A fumigatus and refractory respiratory symptoms.
Implications:
- Consider A fumigatus as a direct respiratory pathogen in CF patients.
- Antifungal therapy is a viable option for CF patients with deteriorating respiratory function and A fumigatus in sputum, especially when antibiotic treatment fails.
- This broadens the understanding of A fumigatus's impact on CF lung disease and treatment strategies.
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