Chronic pulmonary aspergillosisCitation formats

  • Authors:
  • European Society for Clinical Microbiology and Infectious Diseases
  • David W Denning
  • Jacques Cadranel
  • Catherine Beigelman-Aubry
  • Florence Ader
  • Arunaloke Chakrabarti
  • Stijn Blot
  • Andrew J Ullmann
  • George Dimopoulos
  • Christoph Lange

Standard

Chronic pulmonary aspergillosis : rationale and clinical guidelines for diagnosis and management. / European Society for Clinical Microbiology and Infectious Diseases ; Denning, David W; Cadranel, Jacques; Beigelman-Aubry, Catherine; Ader, Florence; Chakrabarti, Arunaloke; Blot, Stijn; Ullmann, Andrew J; Dimopoulos, George; Lange, Christoph.

In: The European respiratory journal, Vol. 47, No. 1, 31.12.2015, p. 45-68.

Research output: Contribution to journalArticle

Harvard

European Society for Clinical Microbiology and Infectious Diseases, Denning, DW, Cadranel, J, Beigelman-Aubry, C, Ader, F, Chakrabarti, A, Blot, S, Ullmann, AJ, Dimopoulos, G & Lange, C 2015, 'Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management', The European respiratory journal, vol. 47, no. 1, pp. 45-68. https://doi.org/10.1183/13993003.00583-2015

APA

European Society for Clinical Microbiology and Infectious Diseases, Denning, D. W., Cadranel, J., Beigelman-Aubry, C., Ader, F., Chakrabarti, A., ... Lange, C. (2015). Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. The European respiratory journal, 47(1), 45-68. https://doi.org/10.1183/13993003.00583-2015

Vancouver

European Society for Clinical Microbiology and Infectious Diseases, Denning DW, Cadranel J, Beigelman-Aubry C, Ader F, Chakrabarti A et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. The European respiratory journal. 2015 Dec 31;47(1):45-68. https://doi.org/10.1183/13993003.00583-2015

Author

European Society for Clinical Microbiology and Infectious Diseases ; Denning, David W ; Cadranel, Jacques ; Beigelman-Aubry, Catherine ; Ader, Florence ; Chakrabarti, Arunaloke ; Blot, Stijn ; Ullmann, Andrew J ; Dimopoulos, George ; Lange, Christoph. / Chronic pulmonary aspergillosis : rationale and clinical guidelines for diagnosis and management. In: The European respiratory journal. 2015 ; Vol. 47, No. 1. pp. 45-68.

Bibtex

@article{aacd1bcb5e454bbab1ae1bdc30abee5e,
title = "Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management",
abstract = "Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ~240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease. Subacute invasive pulmonary aspergillosis (formerly called chronic necrotising pulmonary aspergillosis) is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. Few clinical guidelines have been previously proposed for either diagnosis or management of CPA. A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of Aspergillus infection (microscopy or culture from biopsy) or an immunological response to Aspergillus spp. and exclusion of alternative diagnoses, all present for at least 3 months. Aspergillus antibody (precipitins) is elevated in over 90{\%} of patients. Surgical excision of simple aspergilloma is recommended, if technically possible, and preferably via video-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, arrest haemoptysis and prevent progression. Careful monitoring of azole serum concentrations, drug interactions and possible toxicities is recommended. Haemoptysis may be controlled with tranexamic acid and bronchial artery embolisation, rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. Patients with single Aspergillus nodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up.",
keywords = "Antifibrinolytic Agents, Antifungal Agents, Aspergillosis, Allergic Bronchopulmonary, Bronchial Arteries, Bronchoscopy, Chronic Disease, Disease Management, Embolization, Therapeutic, Hemoptysis, Humans, Immunocompetence, Immunocompromised Host, Invasive Pulmonary Aspergillosis, Lung, Mycetoma, Pulmonary Aspergillosis, Thoracic Surgery, Video-Assisted, Tomography, X-Ray Computed, Tranexamic Acid, Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't",
author = "{European Society for Clinical Microbiology and Infectious Diseases} and Denning, {David W} and Jacques Cadranel and Catherine Beigelman-Aubry and Florence Ader and Arunaloke Chakrabarti and Stijn Blot and Ullmann, {Andrew J} and George Dimopoulos and Christoph Lange",
note = "Copyright {\circledC}ERS 2016.",
year = "2015",
month = "12",
day = "31",
doi = "10.1183/13993003.00583-2015",
language = "English",
volume = "47",
pages = "45--68",
journal = "The European respiratory journal",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "1",

}

RIS

TY - JOUR

T1 - Chronic pulmonary aspergillosis

T2 - rationale and clinical guidelines for diagnosis and management

AU - European Society for Clinical Microbiology and Infectious Diseases

AU - Denning, David W

AU - Cadranel, Jacques

AU - Beigelman-Aubry, Catherine

AU - Ader, Florence

AU - Chakrabarti, Arunaloke

AU - Blot, Stijn

AU - Ullmann, Andrew J

AU - Dimopoulos, George

AU - Lange, Christoph

N1 - Copyright ©ERS 2016.

PY - 2015/12/31

Y1 - 2015/12/31

N2 - Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ~240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease. Subacute invasive pulmonary aspergillosis (formerly called chronic necrotising pulmonary aspergillosis) is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. Few clinical guidelines have been previously proposed for either diagnosis or management of CPA. A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of Aspergillus infection (microscopy or culture from biopsy) or an immunological response to Aspergillus spp. and exclusion of alternative diagnoses, all present for at least 3 months. Aspergillus antibody (precipitins) is elevated in over 90% of patients. Surgical excision of simple aspergilloma is recommended, if technically possible, and preferably via video-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, arrest haemoptysis and prevent progression. Careful monitoring of azole serum concentrations, drug interactions and possible toxicities is recommended. Haemoptysis may be controlled with tranexamic acid and bronchial artery embolisation, rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. Patients with single Aspergillus nodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up.

AB - Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ~240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease. Subacute invasive pulmonary aspergillosis (formerly called chronic necrotising pulmonary aspergillosis) is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. Few clinical guidelines have been previously proposed for either diagnosis or management of CPA. A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of Aspergillus infection (microscopy or culture from biopsy) or an immunological response to Aspergillus spp. and exclusion of alternative diagnoses, all present for at least 3 months. Aspergillus antibody (precipitins) is elevated in over 90% of patients. Surgical excision of simple aspergilloma is recommended, if technically possible, and preferably via video-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, arrest haemoptysis and prevent progression. Careful monitoring of azole serum concentrations, drug interactions and possible toxicities is recommended. Haemoptysis may be controlled with tranexamic acid and bronchial artery embolisation, rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. Patients with single Aspergillus nodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up.

KW - Antifibrinolytic Agents

KW - Antifungal Agents

KW - Aspergillosis, Allergic Bronchopulmonary

KW - Bronchial Arteries

KW - Bronchoscopy

KW - Chronic Disease

KW - Disease Management

KW - Embolization, Therapeutic

KW - Hemoptysis

KW - Humans

KW - Immunocompetence

KW - Immunocompromised Host

KW - Invasive Pulmonary Aspergillosis

KW - Lung

KW - Mycetoma

KW - Pulmonary Aspergillosis

KW - Thoracic Surgery, Video-Assisted

KW - Tomography, X-Ray Computed

KW - Tranexamic Acid

KW - Journal Article

KW - Practice Guideline

KW - Research Support, Non-U.S. Gov't

U2 - 10.1183/13993003.00583-2015

DO - 10.1183/13993003.00583-2015

M3 - Article

VL - 47

SP - 45

EP - 68

JO - The European respiratory journal

JF - The European respiratory journal

SN - 0903-1936

IS - 1

ER -