Aspergillus and the paediatric lung

Elpis Hatziagorou, Thomas J. Walsh, John N. Tsanakas, Emmanuel Roilides

Research output: Contribution to journalReview articlepeer-review

Abstract

Aspergillus spp produce a wide range of saprophytic and invasive syndromes in the lungs, including allergic bronchopulmonary aspergillosis (ABPA), aspergilloma and invasive pulmonary aspergillosis (IPA). ABPA results from hypersensitivity to the fungus, and mainly affects patients with asthma or cystic fibrosis (CF). The treatment of choice consists of systemic corticosteroids and itraconazole. Aspergilloma is managed by observation or surgery. IPA is predominantly seen in patients with haematological malignancies, chronic granulomatous disease or immunosuppressive treatment. With the use of aggressive therapies for end-stage CF, such as heart-lung transplantation, the potential for a patient to convert from colonization or ABPA to IPA has increased. Suggestive clinical and radiological findings, supplemented with mycological data using serology and molecular biology, have enhanced the capacity to diagnose IPA in paediatric patients. While voriconazole is considered the first-line therapy in IPA, several other antifungal agents may be appropriate alternatives.

Original languageEnglish (US)
Pages (from-to)178-185
Number of pages8
JournalPaediatric Respiratory Reviews
Volume10
Issue number4
DOIs
StatePublished - Dec 1 2009

Keywords

  • Allergic bronchopulmonary aspergillosis
  • Aspergilloma
  • Children
  • Invasive pulmonary aspergillosis
  • Neonates

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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