aspergillosis
ASPERGILLOSIS
Aspergillosis encompasses a variety of clinical syndromes depending on host immunity factors.
It is caused by Aspergillus, an ubiquitous, soil-dwelling, filamentous fungus that grows on soil, food, dead leaves, household dust, etc. It grows best at 37ºC and the small spores are easily inhaled and deposited deep in the lungs.
The most common pathogens are Aspergillus fumigatus, A. flavus, A. niger and A. terreus.
Aspergilloma is a conglomeration of intertwined Aspergillus hyphae, fibrin, mucus and cellular debris within a pulmonary cavity or an ectatic bronchus.

Surgical Intervention

  • Surgical resection is the definitive treatment for single pulmonary aspergillomas and Aspergillus fungal ball of the paranasal sinus
  • Surgical excision has an important role in the invasion of bone, burn wounds, epidural abscesses and vitreal disease
    • May also be valuable when invasive pulmonary disease fails aggressive antifungal chemotherapy
  • Surgical resection of Aspergillus-infected tissue may be useful in patients with lesions that are near the great vessels or pericardium, lesions causing hemoptysis or uncontrolled bleeding from a single focus, and lesions causing erosion into the pleural space or ribs
  • Localized disease may benefit from debridement (eg sinus aspergillosis, cutaneous aspergillosis) 
  • Should also be considered in Aspergillus osteomyelitis, central nervous system aspergillosis, pericardial infection and endocarditis
  • Another relative indication is the resection of a single pulmonary lesion prior to intensive chemotherapy or hematopoietic stem cell transplantation (HSCT)
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