TREATMENT OF ASPERGILLOSIS AND ASPERGILLOMA There are dozens of different types of aspergillosis effecting many organs of the body. This section provides detailed protocols on the treatment of those infections and details of their most prominent references. NOTE Here are published guidelines for the diagnosis and treatment of Chronic Pulmonary Aspergillosis (2019) There are also details of all the antifungal drugs currently in use and

ASPERGILLOMA

Aspergilloma. An aspergilloma is a rounded conglomerate of fungal hyphae, fibrin, mucus and cellular debris that arises in pre-existing pulmonary cavities that have become colonised with Aspergillus. The risk of developing an aspergilloma within a cavity of 2cm in diameter is 15-20%. The vast majority of fungal balls in the lungs are due to

ANTIBODY TESTING

Antibody tests for fungal infection and fungal allergy have firm place in management for a limited number of diseases notably: The diagnosis and monitoring of treatment of chronic pulmonary aspergillosis Screening for and management of allergic bronchopulmonary aspergillosis (ABPA) The diagnosis and monitoring of treatment of allergic, chronic and granulomatous Aspergillus rhinosinusitis

HISTOPATHOLOGY

Demonstration of fungi in tissue is confirmatory of fungal infection. So the 2008 EORTC/MSG definitions of invasive fungal infection carry these statements for proven infections; Moulds: “Histopathologic, cytopathologic, or direct microscopic examination of a specimen obtained by needle aspiration or biopsy in which hyphae or melanized yeast-like forms are seen accompanied by evidence of CHRONIC ASPERGILLUS SINUSITIS FUNGAL URINARY TRACT INFECTIONS Aspergillus, a zygomycete or other moulds. GU tract infection with the endemic fungi is most. common with blastomycosis, and the major site involved is the prostate gland. Treatment of. these less common infections is the same as that for disseminated infection with these.

organisms.

FUNGAL CULTURE

The most direct and usually conclusive means of establishing the diagnosis of a fungal infection is to grow the fungus from a patient sample. Numerous different samples can yield a fungus, including blood, cerebrospinal fluid, pus, urine, tissue, respiratory samples (sputum, bronchoscopy lavage), pleural, pericardial or peritoneal fluid, skin scraping, hair, nail clippings, oral or vaginal

SARTORYA AURATA

Sigler L, Sutton DA, Gibas CF, Summerbell RC, Noel RK, Iwen PC (2010), Phialosimplex, a new anamorphic genus associated with infections in dogs and having phylogenetic affinity to the Trichocomaceae. CHINESE REMEDIES FOR CANCER The major findings of the report showed that there are certain compounds found in mushrooms that have an anti-cancer effect. These compounds are known as polysaccharides. They appear to act on the host’s immune system rather than directly on the tumour. The main polysaccharides that the report focuses on are Lentinan, Schizophyllan, PSK and PSP. BETA 1,3-D-GLUCAN DETECTION Beta 1,3-D-glucan detection. Detection of 1, 3-β-D-glucan (glucan) in serum is useful in the diagnosis of Pneumocystis jirovecii pneumonia and some invasive fungal infections. Glucan is a fungal cell wall component circulating in the blood of patients and is detected using assays which detect activation of factor G of the coagulation cascade TREATMENT OF ASPERGILLOSIS AND ASPERGILLOMA There are dozens of different types of aspergillosis effecting many organs of the body. This section provides detailed protocols on the treatment of those infections and details of their most prominent references. NOTE Here are published guidelines for the diagnosis and treatment of Chronic Pulmonary Aspergillosis (2019) There are also details of all the antifungal drugs currently in use and

ASPERGILLOMA

Aspergilloma. An aspergilloma is a rounded conglomerate of fungal hyphae, fibrin, mucus and cellular debris that arises in pre-existing pulmonary cavities that have become colonised with Aspergillus. The risk of developing an aspergilloma within a cavity of 2cm in diameter is 15-20%. The vast majority of fungal balls in the lungs are due to

ANTIBODY TESTING

Antibody tests for fungal infection and fungal allergy have firm place in management for a limited number of diseases notably: The diagnosis and monitoring of treatment of chronic pulmonary aspergillosis Screening for and management of allergic bronchopulmonary aspergillosis (ABPA) The diagnosis and monitoring of treatment of allergic, chronic and granulomatous Aspergillus rhinosinusitis

HISTOPATHOLOGY

Demonstration of fungi in tissue is confirmatory of fungal infection. So the 2008 EORTC/MSG definitions of invasive fungal infection carry these statements for proven infections; Moulds: “Histopathologic, cytopathologic, or direct microscopic examination of a specimen obtained by needle aspiration or biopsy in which hyphae or melanized yeast-like forms are seen accompanied by evidence of CHRONIC ASPERGILLUS SINUSITIS FUNGAL URINARY TRACT INFECTIONS Aspergillus, a zygomycete or other moulds. GU tract infection with the endemic fungi is most. common with blastomycosis, and the major site involved is the prostate gland. Treatment of. these less common infections is the same as that for disseminated infection with these.

organisms.

FUNGAL CULTURE

The most direct and usually conclusive means of establishing the diagnosis of a fungal infection is to grow the fungus from a patient sample. Numerous different samples can yield a fungus, including blood, cerebrospinal fluid, pus, urine, tissue, respiratory samples (sputum, bronchoscopy lavage), pleural, pericardial or peritoneal fluid, skin scraping, hair, nail clippings, oral or vaginal

SARTORYA AURATA

Sigler L, Sutton DA, Gibas CF, Summerbell RC, Noel RK, Iwen PC (2010), Phialosimplex, a new anamorphic genus associated with infections in dogs and having phylogenetic affinity to the Trichocomaceae. CHINESE REMEDIES FOR CANCER The major findings of the report showed that there are certain compounds found in mushrooms that have an anti-cancer effect. These compounds are known as polysaccharides. They appear to act on the host’s immune system rather than directly on the tumour. The main polysaccharides that the report focuses on are Lentinan, Schizophyllan, PSK and PSP. BETA 1,3-D-GLUCAN DETECTION Beta 1,3-D-glucan detection. Detection of 1, 3-β-D-glucan (glucan) in serum is useful in the diagnosis of Pneumocystis jirovecii pneumonia and some invasive fungal infections. Glucan is a fungal cell wall component circulating in the blood of patients and is detected using assays which detect activation of factor G of the coagulation cascade TREATMENT OF ASPERGILLOSIS AND ASPERGILLOMA There are dozens of different types of aspergillosis effecting many organs of the body. This section provides detailed protocols on the treatment of those infections and details of their most prominent references. NOTE Here are published guidelines for the diagnosis and treatment of Chronic Pulmonary Aspergillosis (2019) There are also details of all the antifungal drugs currently in use and COURSES & WORKSHOPS ARCHIVE Fungal Biodiversity 2020. This yearly course has now been transformed into a 1-week course. The course provides a concise overview of the biodiversity of organisms representing the Kingdom Fungi. The course focuses on systematics and general ecology of fungi, as well as related topics such as soil mycology and diagnostics of plant

pathogens.

ASPERGILLUS OTOMYCOSIS Aspergillus Otomycosis. Otomycosis is subacute or chronic superficial fungal infection of the external auditory canal and auricle. It is the most frequently encountered fungal infection in ear, nose and throat clinics. The organisms responsible for this clinical entity are usually environmental saprotrophic fungi especially A. niger.

ANTIGEN TESTING

There are 4 antigen tests available with excellent to reasonable clinical performance. Antigen testing is directed against a fungus-synthesised and released carbohydrate into body fluids. These antigens are generally poorly immunogenic and so not usually heavily complexed with specific antibody, with the exception of the Candida mannan antigen. Aspergillus antigen testing Galactomannan is CHRONIC ASPERGILLUS SINUSITIS Chronic rhinosinusitis (CRS) accounts for >90% of all cases of rhinosinusitis, and the correct diagnosis of each category of CRS is important for optimum therapy and predicting the course (Chakrabarti 2009). Fungal organisms are the aetiology agent of CRS in 6-12% of the patients, Aspergillus spp. being the leading cause (Hope, 2005; Laury,

2010).

CHRONIC PULMONARY ASPERGILLOSIS Chronic pulmonary aspergillosis was the first manifestation of pulmonary aspergillosis to be described in man (with an aspergilloma) (Bennett, 1848). Numerous earlier evocative terms have been used previously for CCPA including ‘pulmonary aspergillosis with cavitation’, ‘symptomatic pulmonary aspergilloma’, ‘complex

aspergilloma

FUNGAL CULTURE

The most direct and usually conclusive means of establishing the diagnosis of a fungal infection is to grow the fungus from a patient sample. Numerous different samples can yield a fungus, including blood, cerebrospinal fluid, pus, urine, tissue, respiratory samples (sputum, bronchoscopy lavage), pleural, pericardial or peritoneal fluid, skin scraping, hair, nail clippings, oral or vaginal ONYCHOMYCOSIS DUE TO ASPERGILLUS SPECIES A recent review on the epidemiology of onychomycosis due to Aspergillus species has shown that Aspergillus spp. constitutes up to 7.7–100% of the proportion of NDMO and between