Aspergillosis[1]- Katie Jacquie Qazi.pdf

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    Presentation Developed By:

    Katie Olenick, Jacquie Mohney

    & Qazi Omair

    Aspergillosis

    http://agreenliving.org/tag/about-environment/

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    Names

    • People with Aspergillosis are in three distinct

    groups• Healthy immune system

    Non-invasive Aspergilloma• Chronic pulmonary Aspergillosis (CPA)

    • Allergic bronchopulmonary Aspergillosis (ABPA)

    • Fungal sinusitus (Fungal ball in the sinuses)

    • Otomycosis (Ear infection)

    • Keratitus (Eye infection)

    • Onychomycosis (Nail infection)

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    Names Con’t 

    Damage or nonexistent immune system• Pulmonary Aspergilloma (Lungs)

    • Endocarditis, Mycarditis (Heart)

    • Cerebral Aspergillosis (Brain)

    • Renal Aspergillosis (Kidney)

    • Odteomyelitis (Bone)

    • Gastrointestinal tract

    • Chronic granulomatous disorder• Genetic• 8 to 10 out of millions of people

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    Classification of Taxonomy

    • Kingdom (Fungi)

    • Phylum (Ascomycota)

    • Class (Ascomycetes)

    • Order (Eurotiales)

    • Family (Trichocomacaea)

    • Genus (Aspergillus)

    • Species: A. fumigatus, A. flavus, A. niger, A.

    nidulans, A. terreus

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     Aspergillus fumigatus

    • Filamentous fungus

    • Worldwide

    • Airborne saprophytic fungi• Causes infection

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     A. flavus

    • Produces aflatoxin (most important known

    microtoxins)

    Imperfect ascomycete (does not produceascospores- makes asexual spores)

    • More common in air than A. fumigatus

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     A. niger

    • Multi-nucleate

    • Normally haploid

    Found in agricultural products

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     A. nidulans

    • Ascomycetes

    • All are filamentous fungus

    Asexual spores (Candida)• Sexual spores (Ascospores)

    • Develop 9 different cell types

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     A. terreus

    • Filamentous ascomycete

    • Produce lateral cells termed

    aleuriospores

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    Life Cycle

    • Sarophytes

    • Production of conidia (asexual spores)

    • Primary route of human infection:• Inhalation

    • Conidial deposition

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    http://cmr.asm.org/content/vol22/issue3/images/large/zcm0030922850001.jpeg

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    Epidemiology

    • Most common in individuals with:• Asthma

    •Cystic fibrosis

    • Organ transplant patients

    • Immunosuppressed

    • Corticosteroid-induced patients

    • Neutropenia

    The mortality rate in some groups is ~90%

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    Pathogenesis

    • Innate defenses

    • Inflammatory

    mediators• Ex. Beta-D-

    glucan

    • Risk of the diseaseincreases with the

    combination of:•

    Impacting proximalevents in conidial

    clearance, production of

    inflammation, and

    killing of invasive forms• microbial factors

    impacting disease

    potential https://reader015.{domain}/reader015/html5/0714/5b4900d05fc06/5b4900d8f02b6.jpg

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    •Blood Test•Called ‘aspergillus precipitin test’ 

    •Detects antibodies to aspergillus

    •Imaging•Chest x-ray or CT scan

    •Lung cavity lesion or fungal ball (aspergilloma)

    •Skin Test•Aspergillus Ag injected into skin

    •Allergic reaction indicates circulating IgE

    antibodies specific for aspergillus

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    http://www.humenhealth.com/aspergillosis/aspergillosis.asp

    Pulmonary

    AspergillosisNormal Chest X-Ray

    http://www.broadwayradiology.co.nz/39.html

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    Sputum microscopic analysis•Filamentous fungus

    •Branching septate hyphae

    with 45°angle

    •Silver stains

    http://www.mycology.adelaide.edu.au/Mycoses/Opportunistic/Aspergillosis/

    http://www.mycology.adelaide.edu.au/Fungal_Descriptions/Hyphomycetes_(hyaline)/Aspergillus/fumigatus.html http://www.sickhousecenter.com/mold-pictures/

     A. Fumigatus(left)

     A. Flatus

    (right)

    •Sputum culture

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    •Symptoms

    •Cough

    •Hemoptysis

    •Dyspnea

    •Fever

    •Weight loss

    •Fatigue

    http://www.sciencephoto.com/media/250290/enlarge

    Commonly found•opportunistic infection

    •AIDS

    Cancer patients

    •Similar to

    •lung cancer

    •tuberculosis

    •other lung infections

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    •Oral Corticosteroids•Standard treatment for allergic bronchopulmonary

    aspergillosis to reduce inflammation

    •Will prevent existing asthma or cystic fibrosis from

    worsening

    •Antifungal medication•Standard treatment for invasive pulmonary

    aspergillosis•Historically has been Amphotericin B

    •Newer antifungals such as itraconazole andvoriconazole are now preferred

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    • Male•

    Weakness• Loss of bladder and

    bowel control

    • Spinal epidural abcess•  Aspergillus fumigatus

    • Cauda equina syndrome

    • Treatment• Surgical drainage

    • Voriconazole

    •Intraconazole

    http://healthhackz.com/lower-back-pain-vital-details-about-low-back-soreness/

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    • Increased incidence

    • Preventative measures

    • Hedi Chaker Hospital• Hematology

    • Environmental Factors• Invasive Aspergillosis

    http://www.inmagine.com/dki073/dki073003-photo

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    "Aspergillus/aspergillosis Website." The Aspergillus/Aspergillosis Website. Web. 10July 2011.

    .

    Batra, Sumit, Sumit Arora, Hemant Meshram, Geetika Khanna, Shabnam B. Grover,and Vinod K. Sharma. "A Rare Etiology of Cauda Equina Syndrome." J Infect DevCtries 5.1 (2011): 79-82. Print.

    "CDC - Aspergillosis, General Information - NCZVED." Centers for Disease Controland Prevention. 10 July 2010. Web. 8 July 2011..

    Dagenais, T. R. T., and N. P. Keller. "Pathogenesis of Aspergillus Fumigatus inInvasive Aspergillosis." Clinical Microbiology Reviews 22.3 (2009): 447-65. Print.

    "Descriptions - Aspergillus Comparative." Broad Institute of MIT and Harvard. Web.10 July 2011..

    http://www.mayoclinic.com/health/aspergillosis/DS00950/DSECTION=treatments-and-drugshttp://www.mayoclinic.com/health/aspergillosis/DS00950/DSECTION=treatments-and-drugs

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    Resources Con’t "Diagnosis of Aspergillosis." The Aspergillus/Aspergillosis Website. Web. 8 July

    2011. .

    Harman M.D., Eloise M. "Apergillosis." Medscape Reference. 7 June 2011. Web.

    10 July 2011. .

    "Human Aspergillosis - Home Inspection for Mold Relevant to Human Health."

    Medical Mycologist Medical Toxicologist Certified Health Investigations for Mold

    and Toxins for Health Investigations and Mold Testing with Full Indoor Air Quality

    Analysis.NJ NY EMF Lead Radon Electromagnetic Radiation. Web. 10 July 2011.

    .

    Marr, Kieren A. "Epidemiology and Clinical Manifestations of Invasive

    Aspergillosis." UpToDate Inc. Ed. Carol A. Kauffman and Anna R. Thorner. 2011.

    Web. 8 July 2011. .

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    Resources Cont’d