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08:01
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Recent advances in invasive pulmonary aspergillosis
Louis Yi-Ann Chai1, Li-Yang Hsu
1Department of Medicine, National University Health System Singapore, 1E Kent Ridge Road, Singapore.
Current Opinion in Pulmonary Medicine
|January 22, 2011
Summary
Recent advances in invasive pulmonary aspergillosis (IPA) management offer improved risk stratification and treatment options for immunocompromised patients. However, clinical challenges persist due to impaired host immune response.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hematology
Background:
- Invasive pulmonary aspergillosis (IPA) is a common opportunistic fungal pneumonia in patients with hematological malignancies.
- Other immunosuppressed and critically ill patients are also at risk of IPA.
Purpose of the Study:
- To review recent developments in the diagnosis and management of invasive pulmonary aspergillosis (IPA).
- To highlight advancements in risk stratification and therapeutic strategies for IPA.
Main Methods:
- Review of recent literature on invasive pulmonary aspergillosis.
- Analysis of diagnostic biomarkers and prophylactic/therapeutic antifungal agents.
Main Results:
- Patient risk stratification may be improved by identifying specific polymorphisms in Toll-like receptor 4 and dectin-1.
- Galactomannan assay in bronchoalveolar lavage fluid is undergoing validation for IPA diagnosis, with trending results potentially aiding prognostication.
- Posaconazole and aerosolized liposomal amphotericin B (L-AMB) show efficacy in prophylaxis during intensive chemotherapy for leukemia.
- Fluconazole remains effective for prophylaxis in hematopoietic stem cell transplantation.
- Voriconazole is the preferred treatment for IPA, with caspofungin and L-AMB as viable alternatives.
Conclusions:
- Despite increased knowledge and newer antifungal agents, managing IPA in immunocompromised hosts remains challenging.
- The compromised host defense system's inability to mount an effective immune response complicates clinical management.
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