Lung Diseases Caused by Aspergillus and Pulmonary Eosinophilia
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Aspergillus fumigatus is the most frequent cause of fungal lung disease in humans. The spectrum of aspergillus airways disease ranges from allergic asthma characterised by an IgE-mediated immune response, to allergic bronchopulmonary aspergillosis, where additionally there is airway fungal colonisation and an IgG-mediated immune response leading to bronchiectasis and fibrosis. Chronic pulmonary aspergillosis describes syndromes with varying degrees of fungal invasion and lung destruction. Patients with local or systemic immunocompromise are at risk of locally invasive fungal disease; in its extreme form manifesting as life-threatening invasive aspergillosis in neutropenic patients. Other causes of pulmonary eosinophilia are discussed, including common drug reactions and the relatively rare acute and chronic eosinophilic pneumonias.
KeywordsFungal infection Aspergillosis Drug reaction Allergy Eosinophils Bronchoalveolar lavage Blood count Immunoglobulin E Antifungal drug therapy Infection in immunocompromised host Aspergilloma