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One Tiny Mold, One Big Problem: Aspergillosis
By: Melanie Yodock
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Outline History of Aspergillosis Aspergillus species information
People at Risk Clinical Types Detection/Diagnosis Treatment
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History First noted in 1815 Secondary infection
Associated with certain occupations
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Aspergillus sp. Taxonomy Morphology Named after aspergillum
species species species 5 common species Many rarer species Morphology Saprophytes Small, fluffy, white colonies Pathogenic species can be different colors
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People at Risk AIDS patients Neutropenia Chronic Granulomatous Disease
Solid Organ Transplant Recipients Hematopoietic Stem Cell Transplant Recipients (HSCT)
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Clinical Cases Pulmonary Aspergillosis Aspergillomas
Granulomatous aspergillosis
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Clinical Cases Cont. Otomycosis Aspergillus Sinusitis
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Clinical Cases Cont. Tracheobronchitis Cutaneous Aspergillosis
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Clinical Cases Cont. Cerebral Aspergillosis
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Detection/Diagnosis BAL cultures (1→3)-β-ᴅ-glucan assay
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Detection/Diagnosis CT scans Laboratory Markers and PCR
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Treatment Amphotericin B Voriconazole Itraconazole Caspofungin
Posaconazole
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Summary Aspergillosis has been around for hundreds of years
Secondary infection in immunocompromised patients Many clinical types of aspergillosis New detection techniques are allowing for earlier diagnosis Many treatment options but an ongoing battle with fungal evolution and resistance
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References Denning D.W Invasive Aspergillosis. Clinical Infectious Diseases. 26: Denning D.W., Ribaud P., Milpied N., Caillot D., Herbrecht R., Thiel E., Haas A., Ruhnke M., Lode H Efficacy and Safety of Voriconazole in the Treatment of Acute Invasive Aspergillosis. Clinical Infectious Diseases. 34: Di Somma A., Bailey T., Silvanose C., Garcia-Martinez C The Use of Voriconazole for the Treatment of Aspergillosis in Falcons (Falco Species). Journal of Avian Medicine and Surgery. 21(4): Emmons C.W., Binford C.H., Utz J.P Medical Mycology, Second Edition. Philadelphia: Lea and Febiger, pp Grant S.M., Clissold S.P Itraconazole. Drugs. 37(3): Kendrick B The Fifth Kingdom: Third Edition. Newburyport MA: Focus Publising, pp Marr K.A., Carter R.A., Crippa F., Wald A., Corey L., Epidemiology and Outcome of Mould Infections in Hematopoietic Stem Cell Transplant Recipients. Clinical Infectious Diseases. 34: Ostrosky-Zeichner L., Alexander B.D., Kett D.H., Vazquez J., Pappas P.G., Saeki F., Ketchum P.A., Wingard J., Schiff R., Tamura H., Finkelman M.A., Rex J.H Multicenter Clinical Evaluation of the (1→3)-β-ᴅ-Glucan Assay as an Aid to Diagnosis of Fungal Infections in Humans. Clinical Infectious Diseases. 41: Segal B.H., Walsh T.J Current Approaches to Diagnosis and Treatment of Invasive Aspergillosis. American Journal of Respiratory and Critical Care Medicine. 173: Walsh T.J. Dixon D.M Nosocomial Aspergillosis: Environmental Microbiology, Hospital Epidemiology, Diagnosis and Treatment. European Journal of Epidemiology. 5(2): Wilson J.W., Plunkett O.A The Fungous Diseases of Man. Berkeley: University of California Press, pp
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