Aspergillosis

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  1. Aspergillus spp. are ubiquitous in the environment growing on dead leaves, stored grain, hay, decaying vegetation
  2. Aspergillosis is a large spectrum of diseases caused by members of teh genus Aspergillus, presenting as 3 principal entities: a. allergic brochopulmonary aspergillosis; b. pulmonary aspergilloma; and 3. invasive aspergillosis (pulmonary, CNS, sinonasal, osteomyelitis, endophtalmitis, endocarditis, renal abscess, cutaneous).
  3. Most commonly afflicts immunocompromised host
  4. Diagnosed by direct examination of clinical material mounte din 10% KOH, such as sputum, cerebrospinal fluid, tissue biopsy
  5. CT findings in chest show dense central core surrounded by edema or hemorrhage forming a hazy rim called the halo sign
  6. Tends to be angioinvasive
  7. Treatment:
    1. surgical: resections of aspergillomas
    2. medical : amphotericin B (1-1.5 mg/kg) daily, voriconazole 4mg/Kg q 12h, itraconazole max 600 mg po daily, Capsofungin 50 mg Iv q 24h.
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