pulmonale Aspergillose

Pulmonary aspergillosis is a collective term used to refer to a number of conditions caused by infection with a fungus of the Aspergillus species (usually Aspergillus fumigatus).

There are a number of recognized pulmonary forms, the number depending on the author  . Each form has specific clinical and radiological features and is discussed in separate articles:

• aspergilloma (saprophytic/noninvasive aspergillosis): the most common form seen radiographically
• allergic bronchopulmonary aspergillosis (ABPA)
• invasive aspergillosis
  • subacute invasive pulmonary aspergillosis (previously termed - chronic necrotizing aspergillosis (CNA) or semi-invasive aspergillosis)
  • airway invasive aspergillosis (or bronchopneumonic aspergillosis)
  • angioinvasive aspergillosis
• obstructive bronchopulmonary aspergillosis

Other described groupings include:

• chronic pulmonary aspergillosis
  • chronic cavitary pulmonary aspergillosis
  • chronic fibrosing pulmonary aspergillosis

The remainder of this article discusses general concepts pertaining to pulmonary aspergillosis.

Pathology

The various species of Aspergillus are ubiquitous in the environment, and usually do not cause any human pathology, provided the lungs are structurally normal and the host immunity is intact. If either of these is abnormal, then there is the possibility that this otherwise benign fungus may cause pathology.

Role of immunity in aspergillosis

In a patient with normal immunity, Aspergillus is unable to cause pulmonary pathology. Altered immunity, both heightened (hypersensitivity) or reduced (immunocompromised) predisposes to Aspergillus-related lung disease.

Patients with hypersensitivity may develop allergic bronchopulmonary aspergillosis (ABPA), whereas immunocompromised patients can develop semi-invasive or invasive aspergillosis depending on the degree to which their immune system is depressed.

Role of pulmonary structure in aspergillosis

Aspergillus can colonize pre-existing pulmonary cavities, particularly those left behind by pulmonary tuberculosis. In this setting, the fungus grows and, as it is free to move within the cavity, typically takes on a spherical shape, and is known as an aspergilloma. Other cavities that can predispose to aspergilloma include bullae which may be secondary to emphysema.

See also

• pulmonary fungal infection

Siehe auch:

• pulmonale Tuberkulose
• Aspergillom
• angioinvasive pulmonale Aspergillose
• Allergische bronchopulmonale Aspergillose
• invasive aspergillosis
• Aspergillus fumigatus
• aspergillus
• airway invasive aspergillosis
• obstructive bronchopulmonary aspergillosis
• invasive pulmonale Aspergillose
• chronic necrotising aspergillosis (CNA)
• Emphysem
• pulmonale Pilzinfektionen
• semi-invasive

und weiter:

• pulmonary infection
• Aspergillus flavus
• pulmonary mycosis
• aspergilloma in HIV positive patient