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One Tiny Mold, One Big Problem: Aspergillosis By: Melanie Yodock.

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Presentation on theme: "One Tiny Mold, One Big Problem: Aspergillosis By: Melanie Yodock."— Presentation transcript:

1 One Tiny Mold, One Big Problem: Aspergillosis By: Melanie Yodock

2 Outline O History of Aspergillosis O Aspergillus species information O People at Risk O Clinical Types O Detection/Diagnosis O Treatment

3 History O First noted in 1815 O Secondary infection O Associated with certain occupations

4 Aspergillus sp. O Taxonomy O Named after aspergillum O 1926- 69 species O 1945- 80 species O 1965- 151 species O 5 common species O Many rarer species O Morphology O Saprophytes O Small, fluffy, white colonies O Pathogenic species can be different colors

5 People at Risk O AIDS patients O Neutropenia O Chronic Granulomatous Disease O Solid Organ Transplant Recipients O Hematopoietic Stem Cell Transplant Recipients (HSCT)

6 Clinical Cases O Pulmonary Aspergillosis O Aspergillomas O Granulomatous aspergillosis

7 Clinical Cases Cont. O Otomycosis O Aspergillus Sinusitis

8 Clinical Cases Cont. O Tracheobronchitis O Cutaneous Aspergillosis

9 Clinical Cases Cont. O Cerebral Aspergillosis

10 Detection/Diagnosis O BAL cultures O (1→3)- β --glucan assay

11 Detection/Diagnosis O CT scans O Laboratory Markers and PCR

12 Treatment O Amphotericin B O Voriconazole O Itraconazole O Caspofungin O Posaconazole

13 Summary O Aspergillosis has been around for hundreds of years O Secondary infection in immunocompromised patients O Many clinical types of aspergillosis O New detection techniques are allowing for earlier diagnosis O Many treatment options but an ongoing battle with fungal evolution and resistance

14 References O Denning D.W. 1998. Invasive Aspergillosis. Clinical Infectious Diseases. 26: 781-805. O Denning D.W., Ribaud P., Milpied N., Caillot D., Herbrecht R., Thiel E., Haas A., Ruhnke M., Lode H. 2002. Efficacy and Safety of Voriconazole in the Treatment of Acute Invasive Aspergillosis. Clinical Infectious Diseases. 34: 563-571. O Di Somma A., Bailey T., Silvanose C., Garcia-Martinez C. 2007. The Use of Voriconazole for the Treatment of Aspergillosis in Falcons (Falco Species). Journal of Avian Medicine and Surgery. 21(4): 307-316. O Emmons C.W., Binford C.H., Utz J.P. 1970. Medical Mycology, Second Edition. Philadelphia: Lea and Febiger, pp. 256-274. O Grant S.M., Clissold S.P. 1989. Itraconazole. Drugs. 37(3): 310-344. O Kendrick B. 2000. The Fifth Kingdom: Third Edition. Newburyport MA: Focus Publising, pp.331-332. O Marr K.A., Carter R.A., Crippa F., Wald A., Corey L., 2002. Epidemiology and Outcome of Mould Infections in Hematopoietic Stem Cell Transplant Recipients. Clinical Infectious Diseases. 34: 909-917. O 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. 2005. Multicenter Clinical Evaluation of the (1→3)- β -- Glucan Assay as an Aid to Diagnosis of Fungal Infections in Humans. Clinical Infectious Diseases. 41: 654- 659. O Segal B.H., Walsh T.J. 2006. Current Approaches to Diagnosis and Treatment of Invasive Aspergillosis. American Journal of Respiratory and Critical Care Medicine. 173: 707-717. O Walsh T.J. Dixon D.M. 1989. Nosocomial Aspergillosis: Environmental Microbiology, Hospital Epidemiology, Diagnosis and Treatment. European Journal of Epidemiology. 5(2): 131-142. O Wilson J.W., Plunkett O.A. 1965. The Fungous Diseases of Man. Berkeley: University of California Press, pp. 197-204.

15 Photo References O http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=tItzij0e6 k0RUM&tbnid=hEAB4mdgp6pEaM:&ved=0CAQQjB0&url=http%3A%2F%2Fwww.pennmedicine.org%2Fenc yclopedia%2Fem_PrintArticle.aspx%3Fgcid%3D000127&ei=dvKEUoOSEI3gsATDpIG4DA&bvm=bv.563433 20,d.cWc&psig=AFQjCNEjihPGApdnCB7XdIgjJI2N38YJwg&ust=1384530682850736 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=_zNheCNOViXqIM&tbnid=EC_IxV7 WRRrCJM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fpathhsw5m54.ucsf.edu%2Fcase16%2Faspergilloma. html&ei=3fKEUqn5I5LgsATloYGIBw&psig=AFQjCNEd5dPAn8wO60pgpdCFRozND9PrlA&ust=1384531037 656139 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=EpDzsIaaZAkCsM&tbnid=R68Wjw URJjdzBM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Focw.tufts.edu%2FContent%2F72%2Fimagegallery%2 F1362314%2F1368463%2F1373576&ei=0POEUs_sFI3IsATW04KAAg&psig=AFQjCNFggl1ekrlD- p3Pz7N2QCLh4ve66Q&ust=1384531280406913 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=RugnjnFW- wjqOM&tbnid=LWTLbMnqPUoTqM:&ved=0CAcQjB0wADgO&url=http%3A%2F%2Fen.wikipedia.org%2Fwiki %2FOtitis_externa&ei=BvWEUpfdDMHhsATIyYGwBg&psig=AFQjCNEuCrbmMyANH- 3mXySgDeW54n87GQ&ust=1384531590278613 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=1T_qoymwQDBXHM&tbnid=1JlVhH cxHDPrHM:&ved=0CAcQjB0wADhk&url=http%3A%2F%2Fent4students.blogspot.com%2F2013%2F05%2F ent-pictures-ear.html&ei=gvWEUsnPJIXLsQSlrYDgDg&psig=AFQjCNEwGrjp9PL5rZPCG_CAD- YYIuIchg&ust=1384531714662415

16 Photo References O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=CZ_ZTe0V- cDFBM&tbnid=2KOhucEVndYk2M:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fcare.american- rhinologic.org%2Ffungal_sinusitis&ei=LPaEUtCNG5LdsASsgIL4BA&psig=AFQjCNEaIg8Tc7oCVLFfNtFT7OpIQ fZltg&ust=1384531884517113 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=logsiapAIb4w_M&tbnid=scekzbfB WJL7WM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.aspergillus.org.uk%2Fsecure%2Ftreatment%2Ftr acheo.php&ei=E_eEUvunI47EsATN7IHYDQ&psig=AFQjCNH5TDXWqUrXCbDg0Otwo3V2aAcbEA&ust=13845 32115649199 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=oYaJ- 9EnpItc0M&tbnid=q9UgMnvK2pgrtM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.aspergillus.org.uk%2 Fsecure%2Fimage_library%2Fbrain%2Fbrain9.htm&ei=e_iEUt6NOI_KsQSA4ICYCQ&psig=AFQjCNHhqOrrP6 HkPLnarpEOZm0-QGlF1g&ust=1384532475988280 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=bK5uRmHUlDr2BM&tbnid=wRedX 6JK- eUG5M:&ved=0CAcQjB0wADgT&url=http%3A%2F%2Fwww.lookfordiagnosis.com%2Fmesh_info.php%3Fter m%3DToxoplasmosis%252C%2BCerebral%26lang%3D1&ei=zviEUtW9JYXNsQTU04Aw&psig=AFQjCNHkXu QtjtH9MUyBFymy4YWZp9ISTQ&ust=1384532558682274 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=aJSbLvt7fHN1sM&tbnid=2RHGiZ mj_6Z4nM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.aspergillus.org.uk%2Fsecure%2Fimage_library %2Fflavus%2Fflavbal.html&ei=RwKFUqusI6_MsQSy7IKQCg&psig=AFQjCNEUPPecAbBSOZlvyU4zO75m4UG r4A&ust=1384534983638667

17 Photo References O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=IxiRnAl- wIZ6fM&tbnid=egpN1KV2oI8zJM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwxgrj.en.alibaba.com%2Fprod uct%2F519255747- 200542268%2Fhigh_quality_beta_glucan_1_3_1_6_UV_80_.html&ei=CQOFUomwA7DIsASWqoDYBQ&psi g=AFQjCNG-BcYBuoHAyl-vwFQD74Uwm3Vp3w&ust=1384535177113671 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=HI6k7aLh6azyLM&tbnid=2mdFs4 W6ohe5eM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fmedlibes.com%2Fentry%2Finvasive- aspergillosis&ei=dQSFUtedFdTJsQTw84LQCA&psig=AFQjCNG8aXRbzcXqm1SYwSDeVs1zX1cAxw&ust=138 4535541401422 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=nakt4scBH4lpwM&tbnid=0RLc- ANFZ3ho1M:&ved=0CAcQjB0wADg3&url=http%3A%2F%2Fwww.bio-rad.com%2Fen- rs%2Fproduct%2Fdetection-aspergillus-galactomannan-antigen-eia-microplate- assays&ei=KwWFUoG_GLDlsAT_tYKQAg&psig=AFQjCNEJSnFYLp- mWQ6WD9hJ0Mlc3ytvnA&ust=1384535723472515 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=eBiTHi7F6isu6M&tbnid=fYgAbFvNi gGtKM:&ved=0CAcQjB0wADgU&url=http%3A%2F%2Fnorgenbiotek.com%2Fdisplay- product.php%3FID%3D277&ei=4gWFUs27ErLksASfoIDwBQ&psig=AFQjCNFCev0rRPCs_OdwKrLECrokmWjh YA&ust=1384535906354266 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=WFyCcJ5HbxoqcM&tbnid=PedMLP IO84xxSM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.pc.maricopa.edu%2FBiology%2Frcotter%2FBIO %2520205%2FLessonBuilders%2FChapter%252012%2520LB%2FRevisedCh12LessonBuilder_print.html &ei=ZwaFUozeGtLnsASZyYLgCw&psig=AFQjCNGAOm6wi-G-si- pg8y1wP1XEg1a3A&ust=1384536039514006

18 Photo References O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=W4gzMwEIaCMAkM&tbnid=As3Cg- FKnHa8cM:&ved=0CAcQjB0wAA&url=https%3A%2F%2Fhealthy.kaiserpermanente.org%2Fhealth%2Fcare% 2F!ut%2Fp%2Fc4%2FHYtRCgIxDETPsgcoQbaI-ucZimj9kZDGbrBNS9cVvL2tzPzMmxm4Q5fiRyK- pSgmuIHPHIRE2Yg- S8v_5hTaFg0rfSmV2gcI1_FNhTAxeFazrQO8qmNstIAfqTaMGcFrMYS08GASwFs7H_c7cKyPi4Oa82Hutudp- gGPUoTq%2F&ei=SweFUrONL_DfsATy6IDIAQ&psig=AFQjCNHub2JtAWB6IoQOQyA5JlKQwMYFNw&ust=138 4536267830791 O http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=7AQ5GzrgPYnTdM&tbnid=a7k_42 AiRVhwIM:&ved=0CAcQjB0wADgL&url=http%3A%2F%2Fwww.vetrxdirect.com%2Fproduct%2Fview%2Fitrac onazole&ei=yweFUriJEKfMsQTOxoCwBw&psig=AFQjCNEKakTlNZe6dw6HcjMSdYyf4CuMiQ&ust=13845363 95328053


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