Airway invasive aspergillosis

Airway invasive aspergillosis refers to a form of invasive aspergillosis that affects the airways as the major or only feature.

It usually occurs in immunocompromised neutropenic patients, particularly AIDS patients. Aspergillosis affecting the airways as the major or only feature of the invasive disease is uncommon and is thought to occur in only around 7% of cases of intrathoracic aspergillosis 3.

Clinical manifestations can vary and range from an acute tracheobronchitis, to bronchiolitis to bronchopneumonia.

It is histologically characterised by the presence of Aspergillus organisms deep to the airway basement membrane 1.  

Two morphological forms of invasive aspergillosis of the trachea and bronchi have been described 3 :

  • intraluminal: circumferential and superficial “pseudomembrane” of necrotic tissue, fibrin and hyphae, which may result in airway occlusion
  • multiple nodular plaques: invades adjacent tissues and may lead to broncho-oesophageal and fatal haemorrhage from bronchoarterial fistulation
CT 

The imaging spectrum is variable, depending on whether is it an obstructive tracheobronchitis, bronchiolitis or bronchopneumonia:

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Article information

rID: 21783
System: Chest
Tag: cases
Synonyms or Alternate Spellings:
  • Bronchopneumonic aspergillosis
  • Invasive aspergillosis of the airways

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