Aspergillus pulmonary infection in cystic fibrosis patients – more than just allergic bronchopulmonary aspergillosis A 5-year retrospective study in a pediatric CF Population

Main Article Content

Camilla Buch Kjølbye Tine Wrønding Christine Rønne Hansen Marianne Skov

Abstract

Abstract

Purpose of review:  Among pediatric patients with cystic fibrosis (CF), the Aspergillus is commonly found in sputum causing various pulmonary infections. However, the prevalence and clinical impact is still unclear. The aim was to show prevalence of three Aspergillus pulmonary infections: Aspergillus bronchitis, allergic bronchopulmonary aspergillosis (ABPA) and invasive pulmonary aspergillosis (IPA) in the period 2007-2011 in a pediatric CF population (<18 years), and relate them to gender, age and lung function.

Recent findings: Aspergillus pulmonary infections are a considerable problem among children with CF. Almost 40% of the CF children suffered from an Aspergillus pulmonary infection within the 5-year study period. Aspergillus bronchitis was the most common manifestation, seen from an early age and throughout childhood, whereas ABPA and IPA were rarely seen in children below 7 years of age. We found no difference in gender distribution when comparing the three diagnoses. In the majority of CF patients, lung function declined during an Aspergillus pulmonary infection.

Summary: Aspergillus pulmonary infections in CF patients under the age of 18 years are frequent and probably underestimated. The majority of patients with Aspergillus pulmonary infections experienced a decline in lung function.

Article Details

How to Cite
KJØLBYE, Camilla Buch et al. Aspergillus pulmonary infection in cystic fibrosis patients – more than just allergic bronchopulmonary aspergillosis A 5-year retrospective study in a pediatric CF Population. Medical Research Archives, [S.l.], v. 5, n. 5, may 2017. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1166>. Date accessed: 28 mar. 2024.
Keywords
Cystic fibrosis, children, aspergillus bronchitis, allergic bronchopulmonary aspergillosis, invasive pulmonary aspergillosis
Section
Research Articles

References

Amin, R., Dupuis, A., Aaron, S. D., & Ratjen, F. (2010). The effect of chronic infection with Aspergillus fumigatus on lung function and hospitalization in patients with cystic fibrosis. Chest, 137(1), 171-176. doi: 10.1378/chest.09-1103

Bakare, N., Rickerts, V., Bargon, J., & Just-Nubling, G. (2003). Prevalence of Aspergillus fumigatus and other fungal species in the sputum of adult patients with cystic fibrosis. Mycoses, 46(1-2), 19-23.

Baxter, C. G., Dunn, G., Jones, A. M., & et, a. l. (2013). Novel immunologic classification of aspergillosis in adult cystic fibrosis. J Allergy Clin Immunol, 132(3), 560-566 e510. doi: 10.1016/j.jaci.2013.04.007

Brown, K., Rosenthal, M., & Bush, A. (1999). Fatal invasive aspergillosis in an adolescent with cystic fibrosis. Pediatr Pulmonol, 27(2), 130-133.

Chmiel, J. F., Aksamit, T. R., Chotirmall, S. H., & et, a. l. (2014). Antibiotic management of lung infections in cystic fibrosis. II. Nontuberculous mycobacteria, anaerobic bacteria, and fungi. Ann Am Thorac Soc, 11(8), 1298-1306. doi: 10.1513/AnnalsATS.201405-203AS

Chotirmall, S. H., Al-Alawi, M., Mirkovic, B., & et, a. l. (2013). Aspergillus-associated airway disease, inflammation, and the innate immune response. Biomed Res Int, 2013, 723129. doi: 10.1155/2013/723129

Chotirmall, S. H., & McElvaney, N. G. (2014). Fungi in the cystic fibrosis lung: bystanders or pathogens? Int J Biochem Cell Biol, 52, 161-173. doi: 10.1016/j.biocel.2014.03.001
Drazen, Gill, Griggs, & et, a. l. (2000). Cecil Textbook of Medicine. 401-405.

Kosmidis, C., & Denning, D. W. (2015). The clinical spectrum of pulmonary aspergillosis. Thorax, 70(3), 270-277. doi: 10.1136/thoraxjnl-2014-206291

Kraemer, R., Delosea, N., Ballinari, P., & et, a. l. (2006). Effect of allergic bronchopulmonary aspergillosis on lung function in children with cystic fibrosis. Am J Respir Crit Care Med, 174(11), 1211-1220. doi: 10.1164/rccm.200603-423OC

Latge, J. P. (1999). Aspergillus fumigatus and aspergillosis. Clin Microbiol Rev, 12(2), 310-350.

Lee, T. W., Brownlee, K. G., Conway, S. P., & et, a. l. (2003). Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. J Cyst Fibros, 2(1), 29-34. doi: 10.1016/s1569-1993(02)00141-8

Maiz, L., Cuevas, M., Quirce, S., & et, a. l. (2002). Serologic IgE immune responses against Aspergillus fumigatus and Candida albicans in patients with cystic fibrosis. Chest, 121(3), 782-788.

Massam, J., Bitnun, A., Solomon, M., & et, a. l. (2011). Invasive aspergillosis in cystic fibrosis: a fatal case in an adolescent and review of the literature. Pediatr Infect Dis J, 30(2), 178-180. doi: 10.1097/INF.0b013e3181f63c90

Mastella, G., Rainisio, M., Harms, H. K., & et, a. l. (2000). Allergic bronchopulmonary aspergillosis in cystic fibrosis. A European epidemiological study. Epidemiologic Registry of Cystic Fibrosis. Eur Respir J, 16(3), 464-471.

Mosquera, R. A., Estrada, L., Clements, R. M., & Jon, C. K. (2013). Early diagnosis and treatment of invasive pulmonary aspergillosis in a patient with cystic fibrosis. BMJ Case Rep, 2013. doi: 10.1136/bcr-2013-201360

Sabino, R., Ferreira, J. A., Moss, R. B., & et, a. l. (2014). Molecular epidemiology of Aspergillus collected from cystic fibrosis patients. J Cyst Fibros. doi: 10.1016/j.jcf.2014.10.005

Shoseyov, D., Brownlee, K. G., Conway, S. P., & Kerem, E. (2006). Aspergillus bronchitis in cystic fibrosis. [Case Reports]. Chest, 130(1), 222-226. doi: 10.1378/chest.130.1.222

Stevens, D. A., Moss, R. B., Kurup, V. P., & et, a. l. (2003). Allergic bronchopulmonary aspergillosis in cystic fibrosis--state of the art: Cystic Fibrosis Foundation Consensus Conference. Clin Infect Dis, 37 Suppl 3, S225-264. doi: 10.1086/376525

Wojnarowski, C., Eichler, I., Gartner, C., & et, a. l. (1997). Sensitization to Aspergillus fumigatus and lung function in children with cystic fibrosis. Am J Respir Crit Care Med, 155(6), 1902-1907.