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The clinical spectrum of pulmonary aspergillosis.
[allergic bronchopulmonary aspergillosis]
The
clinical
presentation
of
Aspergillus
lung
disease
is
determined
by
the
interaction
between
fungus
and
host
.
Invasive
aspergillosis
develops
in
severely
immunocompromised
patients
,
including
those
with
neutropenia
,
and
increasingly
in
the
non-neutropenic
host
,
including
lung
transplant
recipients
,
the
critically
ill
patients
and
patients
on
steroids
.
A
high
index
of
suspicion
is
required
in
patients
without
the
classical
risk
factors
as
early
presentation
is
usually
silent
and
non-
specific
,
pyrexia
uncommon
and
timely
treatment
is
crucial
for
survival
.
Invasive
aspergillosis
has
also
been
diagnosed
in
normal
hosts
after
massive
exposure
to
fungal
spores
.
Chronic
pulmonary
aspergillosis
affects
patients
without
obvious
immune
compromise
,
but
with
an
underlying
lung
condition
such
as
COPD
or
sarcoidosis
,
prior
or
concurrent
TB
or
non-tuberculous
mycobacterial
disease
.
Aspergillus
bronchitis
may
be
responsible
for
persistent
respiratory
symptoms
in
patients
with
Aspergillus
detected
repeatedly
in
sputum
without
evidence
of
parenchymal
Aspergillus
disease
,
especially
in
patients
with
bronchiectasis
and
cystic
fibrosis
.
Allergic
bronchopulmonary
aspergillosis
affects
patients
with
asthma
and
cystic
fibrosis
,
and
is
important
to
recognise
as
permanent
lung
or
airways
damage
may
accrue
if
untreated
.
Changes
in
the
classification
of
Aspergillus
allergic
lung
disease
have
been
proposed
recently
.
Cases
of
extrinsic
allergic
alveolitis
and
chronic
pulmonary
aspergillosis
have
been
observed
after
Aspergillus
exposure
.
Asymptomatic
colonisation
of
the
respiratory
tract
needs
close
monitoring
as
it
can
lead
to
clinical
disease
especially
with
ongoing
immunosuppression
.
The
various
syndromes
should
be
viewed
as
a
semicontinuous
spectrum
of
disease
and
one
form
may
evolve
into
another
depending
on
the
degree
of
ongoing
immunosuppression
.
Diseases
Validation
Diseases presenting
"but with an underlying lung condition such as copd or sarcoidosis"
symptom
allergic bronchopulmonary aspergillosis
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