Aspergillus and cystic fibrosis: old disease - new classifications.

[allergic bronchopulmonary aspergillosis]

Aspergillus pulmonary infection has traditionally been recognized as a clinical spectrum of increasing pathogenicity , encompassing saprophytic airways colonization historically regarded of doubtful clinical significance , to allergic bronchopulmonary aspergillosis , chronic cavitatory and life-threatening invasive disease in the immunocompromised host . Whilst the latter two categories are rarely encountered in cystic fibrosis (CF ), there is recognition of an extending spectrum of disease yet to be reflected in consensus management guidelines . The purpose of this review is to provide an up-to -date overview of this extending spectrum , with a focus on disease categories and their clinical significance .Conflicting evidence regarding the clinical significance of Aspergillus colonization and sensitization in CF , alongside the emergence of a novel disease category 'Aspergillus bronchitis ', has led to proposals for the reclassification of Aspergillus disease . In addition , lack of standardization and poor sensitivity of culture-dependent mycology techniques renders clinical and epidemiological interpretation of these isolates challenging .The role of Aspergillus in the absence of established CF -allergic bronchopulmonary aspergillosis remains unclear . The following review discusses new approaches proposed to categorise the extended spectrum of CF Aspergillus disease , highlighting the need for enhanced microbiological investigation and serological monitoring of patients in light of evidence which differentiates colonization from categories of greater pathogenic potential .

Diseases
Validation

Diseases presenting "poor sensitivity of culture-dependent mycology techniques renders clinical and epidemiological interpretation of these isolates challenging" symptom

allergic bronchopulmonary aspergillosis

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