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[1] Crompton G.K., Fungal Disease in: Respiratory medicine, Ed Brewis, Gibson and Geddes, Bailliere Tindall, 1990, 1035–1049 [2] Binder R., Faling L., Pugath R., Mahasaen C., Snider G., Chronic Necrotizing Pulmonary Aspergillosis: a discrete clinical entity, Medicine, 1982, 61, 109–124 [3] Richardson M.D. and Warnock D.W., Fungal Infection: Diagnosis and Management, 2nd ed., Blackwell Scientific Publications, Oxford, 1997 [4] Warnock D.W. and Richardson M.D. Fungal infection in the compromised patients, 2nd ed

Introduction Chronic pulmonary aspergillosis (CPA) is an uncommon destructive pulmonary syndrome, caused by fungi belonging to Aspergillus genus, and it is characterised by slowly progressive cavitation (except Aspergillus nodules), fibrosis and pleural thickening. It usually affects persons without an evident immune suppression but frequently with an underlying pulmonary condition such as chronic obstructive pulmonary disease (COPD), sarcoidosis, non-tuberculous mycobacterial pulmonary disease (NTM-PD) or pulmonary tuberculosis (PTB), prior or concurrent

, Griffin FM. Invasive pulmonary aspergillosis in non-immunocompromised, non-neutropenic hosts. Rev Infect Dis 1986; 8: 357–363 [8] Horn CL, Wood NC, Hughes JA. Invasive pulmonary aspergillosis following post influenza pneumonia. Br J Dis Chest 1983; 77: 407–410 [9] Rinaldi MG. Invasive aspergillus. Rev Znfect Dis 1983; 5: 1061–1077 [10] Grizzanti JN, Knapp A. Diabetic ketoacidosis and invasive aspergillosis. Lung 1981; 159: 43ȁ349 http

1 Introduction The number of community and hospitalized patients with compromised host defenses has increased dramatically in recent years. This increase is due mainly to the significant progress in transplantation procedures, the rapid development of cancer chemotherapy and immunotherapy, and the broader use of corticosteroids [ 1 ]. Invasive pulmonary aspergillosis (IPA) is one of the devastating comorbidities of immunosuppression, especially in patients with immune dysfunction [ 2 ]. CD8 + T cells are a vital component of the adaptive immune system and

against aspergillosis. Med Mycol 2005 ; 43 (Suppl 1 ): S155 –63. 5. Saxena S, Madan T, Shah A, Muralidhar K, Sarma PU. Association of polymorphisms in the collagen region of SP-A2 with increased levels of total IgE antibodies and eosinophilia in patients with allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol 2003 ; 111 : 1001 –7. 6. Crosdale DJ, Poulton KV, Ollier WE, Thomson W, Denning DW. Mannose-binding lectin gene polymorphisms as susceptibility factor for chronic necrotizing pulmonary aspergillosis. J Infect Dis 2001 ; 184 : 653 –6. 7. Rosenberg

The atopic constitution - pulmonary aspergillosis All human beings (except for those with the extremely rare dysgamma- globulinaemia) have immunoglobulin IgE and therefore are potentially capable of manifesting the signs and symptoms of atopic disease. In their lifetime, 10% of all people exhibit major allergy, such as asthma, hay fever, urticaria and/or angioedema and eczema. Another 40% manifest some minor allergy such as a drug or gastrointestinal one, both of which are thought to be IgE mediated. The other 50% may never demonstrate their capability of

superoxide production. Nat Genet.1995; 9: 202-9. 4. Liese J, Kloos S, Jendrossek V, Petropoulou T, Wintergerst U, Notheis G, et al. Long-term follow-up and outcome of 39 patients with chronic granulomatous disease. J Pediatr. 2000; 137:687-93. 5. Moskaluk CA, Pogrebniak HW, Pass HI, Gallin JI, Travis WD. Surgical pathology of the lung in chronic granulomatous disease. Am J Clin Pathol. 1994; 102: 684-91. 6. Chusid MJ, Sty JR, Wells RG. Pulmonary aspergillosis appearing as chronic nodular disease in chronic granulomatous disease. Pediatr Radiol. 1988; 18:232-4. 7. Brodoefel

4 Imaging findings of pulmonary aspergillosis in AIDS 4.1 Introduction Pulmonary aspergillosis (PA) is a kind of infectious, progressive and allergic disease caused by Aspergillus species. Aspergilli are ubiquitous in nature and can be found in water, soil, food, air and decomposing organisms. The common pathogenic species are Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger. Aspergillus is a kind of opportunistic pathogen that may cause diseases in the condition of host immunosuppressed status of the host or comprehensive invasion of a


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