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Aspergillosis of lungs

Numerous strains aspergill potentially pathogens for the person. The range of changes in lungs is very wide and depends on a type of contact and a condition of an organism of the owner. Allergic reaction meets with a bronchospasm more often. In most cases an allergic bronchopulmonary aspergillosis is observed at children with chronic pulmonary diseases. Some patients have an immunological reaction which caused its development, it was genetically determined. Aspergillomas, as a rule, appear in expanded bronchial tubes or an inveterate tubercular cavity. Usually they proceed asymptomatically. However there are messages on separate cases of penetration aspergill in parenchymatous bodies of healthy children, but an invasive aspergillosis usually develops at patients, treated immunodepressants.
Clinical manifestations. It is possible to think of an allergic aspergillosis at chronically sick children or persons with reduced immune responses at which rather sharply appear cough, goose breathing and subfebrile condition. Cough can be with the phlegm sometimes containing brown traffic jams in which at microscopic examination mycelium threads are found. Aspergilla can be received at crops of a phlegm.
At many patients multiple strips of precipitation at diffusion of serum against antigen are defined aspergill. Immediate reaction of skin tests in many cases of a vysokopolozhiteln, and after them it is usually possible to observe reaction of hypersensitivity like III (Artyus). On the roentgenogram of a thorax extensive infiltrates are visible passing, sometimes. Almost at all patients reveal an eosinophilia in peripheral blood. Level of serumal IgE is increased, specific IgE-antibodies to aspergillomas are found. They are often sowed from separated respiratory tracts at chronic pulmonary diseases at persons who have no symptoms of an allergic aspergillosis. Their identification in such cases, and also lack of serological data on hypersensitivity do not serve as the indication for treatment of the patient.
Treatment has to be directed to removal of the activator from an organism. Unfortunately, not clearly, what method is more preferable. There can be effective an intravenous administration of an amfoterptsin In in a dose of 0,25 — 1,0 mg/kg a day or a 5-ftortsitozin in a dose of 50 — 150 mg/kg a day. Some specialists recommended to apply Amphotericinum in the form of an aerosol or direct instillation in a trachea, however its adequate dose was not established. In certain cases use in the form of aerosols or systemically the drugs expanding bronchial tubes, pl of corticosteroids can be required. Treatment by kromolinom-sodium inefficiently.

At aspergillomas specific antifungal means can be effective. However method of the choice surgical excision of the center of defeat with local instillation of Amphotericinum is considered. Irrespective of treatment the forecast is connected mainly with the cornerstone chronic disease. An invasive aspergillosis can be so fulminating that antifungal means have no effect. Patients are usually treated Amphotericinum In in combination with 5-ftortsitoziny during 2 — 3   weeks.

 
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