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- Title
INVASIVE FUNGAL INFECTION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD).
- Authors
Badali, Hamid; Davoudi, Mehrnaz Mohammad; Khodaveisi, Sadegh
- Abstract
In recent years, the incidence of fungal infection has dramatically increased, especially pulmonary infection by the genus Aspergillus among patients with chronic obstructive pulmonary disease. COPD is a frequent disorder for cigarette smoking which is the most remarkably encountered as a risk factor. Nearly 1%-2% of fatal cases of IPA occur in COPD patients. It has been estimated that COPD will become the 3rd leading cause of death worldwide by 2020. The chronic airflow limitation characteristic of COPD is caused by a mixture of small airway and parenchymal destruction. The latter disorder is also a chronic inflammatory disease which increased the numbers of specific inflammatory cell types in lung airways. These changes in the lungs increase with the disease severity (mild to very sever COPD). Invasive pulmonary aspergillosis (IPA) is a life-threatening pneumonia characterized by lung parenchyma invasion with vasculature erosion and necrosis that is caused by airborne opportunistic fungi belonging to the species Aspergillus. Aspergillus fumigatus is the most common species recovered from patients with IPA. Not only IPA occurs in immunocompromised host, but also healthy individuals like patient with obstructive pulmonary disease and intensive care unit (ICU) patients are as targets. The diagnosis of IPA is hard to establish, because of delay in implementing accurate antifungal therapy and the high mortality rate. Accurate and reliable diagnosis of IPA is adjusted based on tissue biopsy evidencing Aspergillus spp. on microscopic examination or in culture. The results from culture and microscopy of respiratory tract samples have <50% sensitivity and specificity. Other diagnostic approach would be useful such as computed tomography scan, non-culture based methods either in serum or in bronchoalveolar lavage (BAL) for detection of antibody and antigen. Molecular investigations based on PCR have predictive values that need to be further investigated in COPD patients. Antifungal therapy using azole agents like voriconazole is recommended as a first-line treatment of IPA.
- Subjects
MYCOSES; OBSTRUCTIVE lung diseases; ASPERGILLUS; CIGARETTE smokers; DISEASE risk factors; NECROSIS; COMPUTED tomography; DISEASES
- Publication
Jundishapur Journal of Microbiology, 2013, p7
- ISSN
2008-3645
- Publication type
Article