Infrequent Infections in COPD

Authors: Domingo, Christian; Jose Masdeu, M; Gallego, Miguel

Source: Current Respiratory Medicine Reviews, Volume 2, Number 4, November 2006 , pp. 357-371(15)

Publisher: Bentham Science Publishers

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Abstract:

Due to their long survival and high cumulative corticosteroid dose, COPD patients become susceptible to unusual microorganisms that commonly affect immunosuppressed patients. Among them, fungi such as Aspergillus and Pneumocystis jiroveci and a bacterium Nocardia, a slow growing Gram-positive and acid-fast staining filamentous branching rod, have been reported in the last decade.

Aspergillus can affect immunocompromised patients in different ways: by colonizing a cavity (aspergilloma), by local chronic invasion of lung parenchyma (chronic necrotizing aspergillosis or semi-invasive aspergillosis) or through a devastating vascular dissemination disease (invasive pulmonary aspergillosis).

Nocardia is a pathogen that tends to act opportunistically, although it has also been reported in immunocompetent patients. It causes chronic lung infection, although systemic nocardiosis with or without central nervous system involvement is quite often found.

Before the AIDS epidemic, Pneumocystis jiroveci (formerly known as Pneumocystis carinii f.sp. hominis) was known to affect malnourished patients. Recently it has been found colonizing chronic respiratory patients with conditions such as COPD or cystic fibrosis,but its role in the pathogenesis or evolution of COPD deterioration is unknown.

The clinical presentation, diagnosis and therapeutic approach of each type of infection is discussed herein.

Keywords: Aspergillus spp; chronic necrotizing pulmonary aspergillosis (CNPA); Invasive pulmonary aspergillosis (IPA); Polyenes; Nocardia spp; Azoles

Document Type: Research article

DOI: http://dx.doi.org/10.2174/157339806778777285

Affiliations: 1: Pulmonary Service, Corporacio Parc Tauli, Parc Tauli s/n, 08 208 Sabadell, Barcelona, Spain.

Publication date: 2006-11-01

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Current Respiratory Medicine Reviews publishes frontier reviews on all the latest advances on respiratory diseases and its related areas e.g. pharmacology, pathogenesis, clinical care, and therapy. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in respiratory medicine.

Infrequent Infections in COPD

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