The biology of pulmonary aspergillus infections.

[allergic bronchopulmonary aspergillosis]

Pulmonary aspergillus infections are mainly caused by Aspergillus fumigatus and can be classified based on clinical syndromes into saphrophytic infections , allergic disease and invasive disease . Invasive pulmonary aspergillosis , occurring in immunocompromised patients , reflects the most serious disease with a high case-fatality rate . Patients with cystic fibrosis and severe asthma might develop allergic bronchopulmonary aspergillosis , while saphrophytic infections are observed in patients with lung cavities mainly due to tuberculosis . Histopathologically , a differentiation can be made into angio-invasive and airway-invasive disease . If the host response is too weak or too strong , Aspergillus species are able to cause disease characterized either by damage from the fungus itself or through an exaggerated inflammatory response of the host , in both situations leading to overt disease associated with specific clinical signs and symptoms . The unraveling of the specific host - Aspergillus interaction has not been performed to a great extent and needs attention to improve the management of those clinical syndromes .