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Diagnosis and treatment of pulmonary aspergillosis syndromes.
[allergic bronchopulmonary aspergillosis]
Both
inherited
and
acquired
immunodeficiency
and
chronic
pulmonary
disease
predispose
to
the
development
of
a
variety
of
pulmonary
syndromes
in
response
to
Aspergillus
,
a
fungus
that
is
ubiquitous
in
the
environment
.
These
syndromes
include
invasive
aspergillosis
,
which
is
now
recognized
to
occur
in
patients
with
critical
illness
without
neutropenia
and
in
those
with
mild
degrees
of
immunosuppression
,
including
from
corticosteroid
use
in
the
setting
of
COPD
.
Chronic
pulmonary
aspergillosis
includes
simple
aspergilloma
,
which
is
occasionally
complicated
by
life-threatening
hemoptysis
,
and
progressive
destructive
cavitary
disease
requiring
antifungal
therapy
.
Allergic
bronchopulmonary
aspergillosis
occurs
almost
exclusively
in
patients
with
asthma
or
cystic
fibrosis
.
Recent
advances
in
each
of
these
syndromes
include
a
greater
understanding
of
the
underlying
pathophysiology
and
hosts
at
risk
;
improved
diagnostic
algorithms
;
and
the
availability
of
more
effective
and
well-tolerated
therapies
.
Improvement
in
outcomes
for
Aspergillus
pulmonary
syndromes
requires
that
physicians
recognize
the
varied
and
sometimes
subtle
presentations
,
be
aware
of
populations
at
risk
of
illness
,
and
institute
potentially
life-saving
therapies
early
in
the
disease
course
.
Diseases
Validation
Diseases presenting
"chronic pulmonary disease predispose to the development of a variety of pulmonary syndromes in response to aspergillus"
symptom
allergic bronchopulmonary aspergillosis
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