000 Aspergillosis Invasive Form

  • Buzzwords
    • serious infection,
    • may be systemic
    • immunocompromised
  • Invasive Aspergillosis:
    • A severe fungal infection caused by Aspergillus species.
    • Primarily affects individuals with weakened immune systems,
      • transplant recipients,
      • chemotherapy patients, and those with
      • HIV/AIDS.
      • Also
        • chronic obstructive pulmonary disease (COPD)
  • Symptoms:
    • Fever, often unresponsive to antibiotics.
    • Chest pain.
    • Cough with or without blood.
    • Shortness of breath.
    • Fatigue.
  • DiagnosisCT scans
    • Halo Sign:
      An early sign often seen in neutropenic patients.

      • Presents as a central area of lung attenuation (ground-glass opacity) surrounded by a rim of consolidation.
      • Indicates hemorrhage and edema around the infected area.
    • Reversed Halo Sign:
    • Nodules and Masses:
      • As the infection progresses, nodules and masses can develop in the lung tissue.
      • Irregular borders and variable enhancement patterns are typical.
      • Nodules can cavitate, leading to the air crescent sign.
    • Pneumonia
    • Cavitation and Necrosis:
      • Advanced invasive aspergillosis can lead to cavitation and necrosis of lung tissue.
      • Cavities may contain fungal elements, blood, and debris.
  • Angioinvasive Aspergillosis:
    • subtype of invasive aspergillosis.
    • refers to the tendency of the Aspergillus hyphae to
      • invade and infiltrate blood vessels  particularly the small
      • causes
        • vessel damage,
        • thrombosis
        • tissue infarction
      • Pleural Involvement:
        • In severe cases, infection can extend to the pleura.
        • Pleural effusion and pleural thickening may be observed.
      • Distribution:
        • Lesions are often multiple and can be bilateral.
        • More commonly found in the upper lobes and periphery of the lungs.
    • Laboratory tests including blood cultures and biomarker tests (such as galactomannan or β-D-glucan).
  • Treatment:
    • Antifungal medications (voriconazole, isavuconazole, or other options based on susceptibility).
    • Intravenous therapy followed by oral treatment.
    • Close monitoring of drug levels and potential interactions, especially in patients on multiple medications.
  • Prognosis:
    • Mortality rates can be high, especially in severely immunocompromised individuals.
    • Early diagnosis and prompt treatment are critical for better outcomes.
    • Prognosis improves if underlying immune issues can be addressed.
  • Prevention:
    • Minimizing exposure to environmental mold and fungi, especially in healthcare settings.
    • Taking appropriate precautions for individuals with weakened immune systems.
    • Timely administration of antifungal prophylaxis in high-risk patients.