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One Tiny Mold, One Big Problem: Aspergillosis

One Tiny Mold, One Big Problem: Aspergillosis. By: Melanie Yodock. Outline. History of Aspergillosis Aspergillus species information People at Risk Clinical Types Detection/Diagnosis Treatment. History. First noted in 1815 Secondary infection Associated with certain occupations.

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One Tiny Mold, One Big Problem: Aspergillosis

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  1. One Tiny Mold, One Big Problem: Aspergillosis By: Melanie Yodock

  2. Outline • History of Aspergillosis • Aspergillus species information • People at Risk • Clinical Types • Detection/Diagnosis • Treatment

  3. History • First noted in 1815 • Secondary infection • Associated with certain occupations

  4. Aspergillus sp. • Taxonomy • Named after aspergillum • 1926- 69 species • 1945- 80 species • 1965- 151 species • 5 common species • Many rarer species • Morphology • Saprophytes • Small, fluffy, white colonies • Pathogenic species can be different colors

  5. People at Risk • AIDS patients • Neutropenia • Chronic Granulomatous Disease • Solid Organ Transplant Recipients • Hematopoietic Stem Cell Transplant Recipients (HSCT)

  6. Clinical Cases • Pulmonary Aspergillosis • Aspergillomas • Granulomatous aspergillosis

  7. Clinical Cases Cont. • Otomycosis • Aspergillus Sinusitis

  8. Clinical Cases Cont. • Tracheobronchitis • Cutaneous Aspergillosis

  9. Clinical Cases Cont. • Cerebral Aspergillosis

  10. Detection/Diagnosis • BAL cultures • (1→3)-β-ᴅ-glucan assay

  11. Detection/Diagnosis • CT scans • Laboratory Markers and PCR

  12. Treatment • Amphotericin B • Voriconazole • Itraconazole • Caspofungin • Posaconazole

  13. Summary • Aspergillosis has been around for hundreds of years • Secondary infection in immunocompromised patients • Many clinical types of aspergillosis • New detection techniques are allowing for earlier diagnosis • Many treatment options but an ongoing battle with fungal evolution and resistance

  14. References • Denning D.W. 1998. Invasive Aspergillosis. Clinical Infectious Diseases. 26: 781-805. • Denning D.W., Ribaud P., Milpied N., Caillot D., Herbrecht R., Thiel E., Haas A., Ruhnke M., Lode H. 2002. Efficacy and Safety of Voriconazole in the Treatment of Acute Invasive Aspergillosis. Clinical Infectious Diseases. 34: 563-571. • Di Somma A., Bailey T., Silvanose C., Garcia-Martinez C. 2007. The Use of Voriconazole for the Treatment of Aspergillosis in Falcons (Falco Species). Journal of Avian Medicine and Surgery. 21(4): 307-316. • Emmons C.W., Binford C.H., Utz J.P. 1970. Medical Mycology, Second Edition. Philadelphia: Lea and Febiger, pp. 256-274. • Grant S.M., Clissold S.P. 1989. Itraconazole. Drugs. 37(3): 310-344. • Kendrick B. 2000. The Fifth Kingdom: Third Edition. Newburyport MA: Focus Publising, pp.331-332. • Marr K.A., Carter R.A., Crippa F., Wald A., Corey L., 2002. Epidemiology and Outcome of Mould Infections in Hematopoietic Stem Cell Transplant Recipients. Clinical Infectious Diseases. 34: 909-917. • Ostrosky-Zeichner L., Alexander B.D., Kett D.H., Vazquez J., Pappas P.G., Saeki F., Ketchum P.A., Wingard J., Schiff R., Tamura H., Finkelman M.A., Rex J.H. 2005. Multicenter Clinical Evaluation of the (1→3)-β-ᴅ-Glucan Assay as an Aid to Diagnosis of Fungal Infections in Humans. Clinical Infectious Diseases. 41: 654-659. • Segal B.H., Walsh T.J. 2006. Current Approaches to Diagnosis and Treatment of Invasive Aspergillosis. American Journal of Respiratory and Critical Care Medicine. 173: 707-717. • Walsh T.J. Dixon D.M. 1989. Nosocomial Aspergillosis: Environmental Microbiology, Hospital Epidemiology, Diagnosis and Treatment. European Journal of Epidemiology. 5(2): 131-142. • Wilson J.W., Plunkett O.A. 1965. The Fungous Diseases of Man. Berkeley: University of California Press, pp. 197-204.

  15. Photo References • http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=tItzij0e6k0RUM&tbnid=hEAB4mdgp6pEaM:&ved=0CAQQjB0&url=http%3A%2F%2Fwww.pennmedicine.org%2Fencyclopedia%2Fem_PrintArticle.aspx%3Fgcid%3D000127&ei=dvKEUoOSEI3gsATDpIG4DA&bvm=bv.56343320,d.cWc&psig=AFQjCNEjihPGApdnCB7XdIgjJI2N38YJwg&ust=1384530682850736 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=_zNheCNOViXqIM&tbnid=EC_IxV7WRRrCJM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fpathhsw5m54.ucsf.edu%2Fcase16%2Faspergilloma.html&ei=3fKEUqn5I5LgsATloYGIBw&psig=AFQjCNEd5dPAn8wO60pgpdCFRozND9PrlA&ust=1384531037656139 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=EpDzsIaaZAkCsM&tbnid=R68WjwURJjdzBM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Focw.tufts.edu%2FContent%2F72%2Fimagegallery%2F1362314%2F1368463%2F1373576&ei=0POEUs_sFI3IsATW04KAAg&psig=AFQjCNFggl1ekrlD-p3Pz7N2QCLh4ve66Q&ust=1384531280406913 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=RugnjnFW-wjqOM&tbnid=LWTLbMnqPUoTqM:&ved=0CAcQjB0wADgO&url=http%3A%2F%2Fen.wikipedia.org%2Fwiki%2FOtitis_externa&ei=BvWEUpfdDMHhsATIyYGwBg&psig=AFQjCNEuCrbmMyANH-3mXySgDeW54n87GQ&ust=1384531590278613 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=1T_qoymwQDBXHM&tbnid=1JlVhHcxHDPrHM:&ved=0CAcQjB0wADhk&url=http%3A%2F%2Fent4students.blogspot.com%2F2013%2F05%2Fent-pictures-ear.html&ei=gvWEUsnPJIXLsQSlrYDgDg&psig=AFQjCNEwGrjp9PL5rZPCG_CAD-YYIuIchg&ust=1384531714662415

  16. Photo References • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=CZ_ZTe0V-cDFBM&tbnid=2KOhucEVndYk2M:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fcare.american-rhinologic.org%2Ffungal_sinusitis&ei=LPaEUtCNG5LdsASsgIL4BA&psig=AFQjCNEaIg8Tc7oCVLFfNtFT7OpIQfZltg&ust=1384531884517113 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=logsiapAIb4w_M&tbnid=scekzbfBWJL7WM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.aspergillus.org.uk%2Fsecure%2Ftreatment%2Ftracheo.php&ei=E_eEUvunI47EsATN7IHYDQ&psig=AFQjCNH5TDXWqUrXCbDg0Otwo3V2aAcbEA&ust=1384532115649199 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=oYaJ-9EnpItc0M&tbnid=q9UgMnvK2pgrtM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.aspergillus.org.uk%2Fsecure%2Fimage_library%2Fbrain%2Fbrain9.htm&ei=e_iEUt6NOI_KsQSA4ICYCQ&psig=AFQjCNHhqOrrP6HkPLnarpEOZm0-QGlF1g&ust=1384532475988280 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=bK5uRmHUlDr2BM&tbnid=wRedX6JK-eUG5M:&ved=0CAcQjB0wADgT&url=http%3A%2F%2Fwww.lookfordiagnosis.com%2Fmesh_info.php%3Fterm%3DToxoplasmosis%252C%2BCerebral%26lang%3D1&ei=zviEUtW9JYXNsQTU04Aw&psig=AFQjCNHkXuQtjtH9MUyBFymy4YWZp9ISTQ&ust=1384532558682274 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=aJSbLvt7fHN1sM&tbnid=2RHGiZmj_6Z4nM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.aspergillus.org.uk%2Fsecure%2Fimage_library%2Fflavus%2Fflavbal.html&ei=RwKFUqusI6_MsQSy7IKQCg&psig=AFQjCNEUPPecAbBSOZlvyU4zO75m4UGr4A&ust=1384534983638667

  17. Photo References • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=IxiRnAl-wIZ6fM&tbnid=egpN1KV2oI8zJM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwxgrj.en.alibaba.com%2Fproduct%2F519255747-200542268%2Fhigh_quality_beta_glucan_1_3_1_6_UV_80_.html&ei=CQOFUomwA7DIsASWqoDYBQ&psig=AFQjCNG-BcYBuoHAyl-vwFQD74Uwm3Vp3w&ust=1384535177113671 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=HI6k7aLh6azyLM&tbnid=2mdFs4W6ohe5eM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fmedlibes.com%2Fentry%2Finvasive-aspergillosis&ei=dQSFUtedFdTJsQTw84LQCA&psig=AFQjCNG8aXRbzcXqm1SYwSDeVs1zX1cAxw&ust=1384535541401422 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=nakt4scBH4lpwM&tbnid=0RLc-ANFZ3ho1M:&ved=0CAcQjB0wADg3&url=http%3A%2F%2Fwww.bio-rad.com%2Fen-rs%2Fproduct%2Fdetection-aspergillus-galactomannan-antigen-eia-microplate-assays&ei=KwWFUoG_GLDlsAT_tYKQAg&psig=AFQjCNEJSnFYLp-mWQ6WD9hJ0Mlc3ytvnA&ust=1384535723472515 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=eBiTHi7F6isu6M&tbnid=fYgAbFvNigGtKM:&ved=0CAcQjB0wADgU&url=http%3A%2F%2Fnorgenbiotek.com%2Fdisplay-product.php%3FID%3D277&ei=4gWFUs27ErLksASfoIDwBQ&psig=AFQjCNFCev0rRPCs_OdwKrLECrokmWjhYA&ust=1384535906354266 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=WFyCcJ5HbxoqcM&tbnid=PedMLPIO84xxSM:&ved=0CAcQjB0wAA&url=http%3A%2F%2Fwww.pc.maricopa.edu%2FBiology%2Frcotter%2FBIO%2520205%2FLessonBuilders%2FChapter%252012%2520LB%2FRevisedCh12LessonBuilder_print.html&ei=ZwaFUozeGtLnsASZyYLgCw&psig=AFQjCNGAOm6wi-G-si-pg8y1wP1XEg1a3A&ust=1384536039514006

  18. Photo References • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=W4gzMwEIaCMAkM&tbnid=As3Cg-FKnHa8cM:&ved=0CAcQjB0wAA&url=https%3A%2F%2Fhealthy.kaiserpermanente.org%2Fhealth%2Fcare%2F!ut%2Fp%2Fc4%2FHYtRCgIxDETPsgcoQbaI-ucZimj9kZDGbrBNS9cVvL2tzPzMmxm4Q5fiRyK-pSgmuIHPHIRE2Yg-S8v_5hTaFg0rfSmV2gcI1_FNhTAxeFazrQO8qmNstIAfqTaMGcFrMYS08GASwFs7H_c7cKyPi4Oa82Hutudp-gGPUoTq%2F&ei=SweFUrONL_DfsATy6IDIAQ&psig=AFQjCNHub2JtAWB6IoQOQyA5JlKQwMYFNw&ust=1384536267830791 • http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=7AQ5GzrgPYnTdM&tbnid=a7k_42AiRVhwIM:&ved=0CAcQjB0wADgL&url=http%3A%2F%2Fwww.vetrxdirect.com%2Fproduct%2Fview%2Fitraconazole&ei=yweFUriJEKfMsQTOxoCwBw&psig=AFQjCNEKakTlNZe6dw6HcjMSdYyf4CuMiQ&ust=1384536395328053

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