Airway invasive aspergillosis
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Airway invasive aspergillosis, also known as Aspergillus bronchopneumonia or bronchopneumonic 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 HIV/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.
It is histologically characterized 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-esophageal and fatal hemorrhage from bronchoarterial fistulation
Markers (bronchoalveolar lavage)
some studies have shown galactomannan (GM) detection in bronchoalveolar lavage fluid (BALF) of
The imaging spectrum is variable, depending on whether is it an obstructive tracheobronchitis, bronchiolitis or bronchopneumonia:
most have normal radiographic findings in the acute phase
occasionally, tracheal or bronchial wall thickening may be seen
typically seen as predominantly peribronchial areas of consolidation
rarely, there can be lobar consolidation
it is almost impossible to differentiate Aspergillus bronchopneumonia from bronchopneumonia due to other causes