• Tuberculosis and Respiratory Diseases
• /
• v.45 no.4
• /
• pp.870-875
• /
• 1998

Actinomycosis is a bacterial infection that can affect virtually any site in the body. There are three major forms of actinomycosis: cervicofacial, abdominal, and thoracic. Aspergillus spp. are ubiquitous in the environment in most countries of the world. Pulmonary aspergillosis is clinically classified by aspergilloma, allergic bronchopulmonary aspergillosis and invasive aspergillosis. Actinomyces and Aspergillus, each of them was often reported in case, but mixed infection of both organisms have not been reported. We experienced a case of mixed infection of Actinomyces and Aspergillus involving the same area of the lung in a 62 year-old housewife presented with hemoptysis and solitary pulmonary nodule. Percutaneous needle aspiration and later surgical resection revealed sulfur granule mixed with Aspergillus hyphae in the same lesion. We report this case with a review of the literature.

• Korean Journal of Veterinary Research
• /
• v.42 no.3
• /
• pp.383-387
• /
• 2002

A four-year-old male elk (Cervus elaphus nelsoni) was diagnosed as pulmonary aspergillosis and renal oxalosis. Clinical signs were coughing, sneezing, respiratory distress, salivation, moderate anorexia, and progressive emaciation. Main gross lesions were fibrinopurulent tonsillitis, diffusely fibrinous pleuritis, and distinct lobar pneumonia with purple red in color. Most of the pulmonary lobes had numerous well demarcated 0.5 to 2 cm yellowish white discrete or confluent nodules that were surrounded by pale red zones. Histopathologically, the affected lungs were disseminated necrotizing pyogranulomas including fungal hypae, vasculitis, and diffusely fibronecrotic pleuritis. The renal lesions were composed of extensive tubular necrosis with large numbers of rosette-formation by birefringent oxalate crystals. Aspergillus fumigatus was isolated from lesions of the lungs. It seems to be a first report for pulmonary aspergillalis and renal oxalosis of a farmed elk in Korea.

• Journal of Microbiology and Biotechnology
• /
• v.24 no.8
• /
• pp.1044-1050
• /
• 2014

Since there is no consensus about the most reliable assays to detect invasive aspergillosis from samples obtained by minimally invasive or noninvasive methods, we compared the efficacy of an enzyme-linked immunosorbent assay (ELISA) for galactomannan (GM) detection and quantitative real-time PCR assay (qRT-PCR) for the diagnosis of invasive pulmonary aspergillosis. Neutropenic, male Sprague-Dawley rats (specific pathogen free; 8 weeks old; weight, $200{\pm}20g$) were immunosuppressed with cyclophosphamide and infected with Aspergillus fumigatus intratracheally. Tissue and whole blood samples were harvested on days 1, 3, 5, and 7 post-infection and examined with GM ELISA and qRT-PCR. The A. fumigatus DNA detection sequence was detected in the following number of samples from 12 immunosuppressed, infected rats examined on the scheduled days: day 1 (0/12), day 3 (0/12), day 5 (6/12), and day 7 (8/12) post-infection. The sensitivity and specificity of the qRT-PCR assay was 29.2% and 100%, respectively. Receiver operating characteristic curve (ROC) analysis indicated a Ct (cycle threshold) cut-off value of 15.35, and the area under the curve (AUC) was 0.627. The GM assay detected antigen in sera obtained on day 1 (5/12), day 3 (9/12), day 5 (12/12), and day 7 (12/12) post-infection, and thus had a sensitivity of 79.2% and a specificity of 100%. The ROC of the GM assay indicated that the optimal Ct cut-off value was 1.40 (AUC, 0.919). The GM assay was more sensitive than the qRT-PCR assay in diagnosing invasive pulmonary aspergillosis in rats.

• Clinical and Experimental Pediatrics
• /
• v.58 no.5
• /
• pp.190-193
• /
• 2015

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease due to bronchial colonization of Aspergillus fumigatus that occurs in susceptible patients with asthma or cystic fibrosis. A 10-year-old girl was referred to the Department of Pediatric Pulmonology for persistent consolidations on chest radiography. Pulmonary consolidations were observed in the right upper and left lower lobes and were not resolved with a 4-week prescription of broad-spectrum antibiotics. The patient had a history of atopic dermatitis and allergic rhinitis but no history of asthma. She had no fever but produced thick and greenish sputum. Her breathing sounds were clear. On laboratory testing, her total blood eosinophil count was $1,412/mm^3$ and total serum IgE level was 2,200 kU/L. Aspergillus was isolated in the sputum culture. The A. fumigatus-specific IgE level was 15.4 kU/L, and the Aspergillus antibody test was also positive. A chest computed tomography scan demonstrated bronchial wall thickening and consolidation without bronchiectasis. An antifungal agent was added but resulted in no improvement of pulmonary consolidations after 3 weeks. Pulmonary function test was normal. Methacholine provocation test was performed, revealing bronchial hyperreactivity ($PC_{20}=5.31mg/mL$). Although the patient had no history of asthma or bronchiectasis, ABPA-seropositivity was suspected. Oral prednisolone (1 mg/kg/day) combined with antifungal therapy was started. Pulmonary consolidations began decreasing after 1 week of treatment and completely resolved after 1 month. This is the first observed and treated case of seropositive ABPA in Korean children without previously documented asthma.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.1
• /
• pp.197-203
• /
• 1998

Invasive pulmonary aspergillosis is a disease occuring predominantly in patients with defects in immunity such as neutropenia, hematologic malignancies or with defects in cell-mediated immunity. The isolation of Aspergillus from respiratory tract of normal host usually signifies tracheobronchial colonization, making this diagnosis difficult. There are isolated case reports occuring in normal hosts but most of them were diagnosed postmortem at autopsies indicating that early diagnosis of invasive aspergillosis in normal host is difficult. We describe here a case of invasive aspergillosis in a immunocompetent host diagnosed by lung biopsy which was successfully treated with Amphotericin-B. Invasive pulmonary aspergillosis should be included as one of the differential diagnosis if a patient with pneumonic consolidation does not respond to usual therapy, even if the patient does not have any defect in immunity.

• Journal of Chest Surgery
• /
• v.28 no.7
• /
• pp.689-692
• /
• 1995

Pulmonary aspergilloma is a rare disease, most commonly presenting as secondary invasion of preexisting cavitary disease. Tuberculosis and bronchieetasis were the commonest pre-existing diseases. Between 1990 and 1994, 11 patients[7 male and 4 female underwent thoracotomy for treatment of pulmonary aspergilloma. The mean age was 45.7 years. The most common indication for operation was hemoptysis. Lobectomy was the m&t frequent operation. Major complication occurred in a patient with bronchopleural fistula and treated with open drainage. There was no operative death. It is concluded that elective pulmonary resection is recommended for all patients with aspergilloma who do not constitute prohibitive operative risks.

• Journal of Chest Surgery
• /
• v.30 no.5
• /
• pp.544-547
• /
• 1997

We have experienced a case of pleural aspergillosis. A 50 year old female complained of malaise, anorexia, coughing with sputum, and right sided pleuritic chest pain of two weeks' duration. About ten years ago, she had been treated for pulmonary tuberculosis with medication. Chest radiography showed right pyopneumothorax with cavitation in the rig t upper lung and Chest computed topography revealed right loculated pyopneumothorax with cavity formation suggesting bronchopleural fistula. Decortication and wedge resection with pleurectomy were performed. The postoperative course was satisfactory and has been in good condition up to now. Pleural aspergillosis is a very rare and potentially life-threatening disease, but we have had good results without significant complications by treatment with systemic antifungal drugs and surgical operation.

• Korean Journal of Clinical Pharmacy
• /
• v.33 no.2
• /
• pp.113-121
• /
• 2023

Background: Globally, the number of patients with aspergillosis is increasing, and the mortality rate remains high. This study aimed to investigate prescribing patterns of antifungal drugs for patients with aspergillosis in South Korea using real-world data. Methods: This retrospective cross-sectional study was performed using National Patient Sample (NPS) data collected by the Health Insurance Review and Assessment Service (HIRA) during 2011-2020. The use of antifungal drugs in patients with aspergillosis was investigated. Results:A total of 1374 patients were identified: 333 patients with invasive pulmonary aspergillosis (IPA) (24.2%), 436 patients with other PA (31.7%), 73 patients with other forms of aspergillosis (5.3%), and 532 patients with unspecified aspergillosis (38.7%). The odds of receiving an antifungal prescription were higher for IPA than for other PA (aOR, 0.233; p<0.001), and higher for hematologic malignancies than for respiratory disorders other than cancer or infections (aOR, 10.018; p<0.001). During each hospitalization period, 56.1% (97/173) and 6.4% (11/173) of IPA hospitalizations received voriconazole and itraconazole monotherapy, respectively, whereas 44.3% (27/61) and 27.9% (17/61) of other PA hospitalizations received itraconazole and voriconazole monotherapy, respectively. Among outpatients with IPA, 67.5% (85/126) and 26.2% (33/126) received voriconazole and itraconazole alone, respectively, whereas among outpatients with other PA, 86.1% (68/79) and 12.7% (10/79) received itraconazole and voriconazole alone, respectively, during the year. Conclusion: In Korea, voriconazole monotherapy was preferred in IPA inpatients, and itraconazole monotherapy was preferred in other PA inpatients. In the ambulatory care settings for IPA and other PA, itraconazole monotherapy was preferred.

• Journal of Chest Surgery
• /
• v.24 no.1
• /
• pp.41-47
• /
• 1991

From January, 1980, to August, 1989, 23 patients underwent thoracotomy for treatment of pulmonary aspergillosis on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. There were 12 male and 11 female patients ranging from 23 years to 61 years old[mean age, 40.7 years]. The main clinical symptoms were hemoptysis[91.3%], cough[65.2%], chest pain[34.5%]. Sixteen patients[69.6%] had simple aspergilloma and 7[30.4%] had complex aspergilloma. The most common indication for operation was a hemoptysis, indeterminate mass, chronic cough, or obstructed bronchus. Anatomical location of lesion was mainly located upper lobe [82.6%] and most of cases were managed by lobectomy. Postoperative pathologic findings showed that 13 case[56.5%] were combined with tuberculosis, two were combined with bronchiectasis and two were combined with lung tumor, but 6 cases were not combined with other disease. Early complications occurred in 33.5% of patients with simple aspergilloma and in 85.7% of patients with complex aspergilloma. But there was no hospital death.

• The Korean Journal of Legal Medicine
• /
• v.42 no.4
• /
• pp.164-167
• /
• 2018

Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.