Singh Ranjan K
Internal Medicine, Anti-Retroviral Therapy Centre, District Hospital, Khagaria, IND.
Cureus. 2021 Apr 20;13(4):e14588. doi: 10.7759/cureus.14588.
Chronic pulmonary aspergillosis (CPA) is caused by saprophytic fungi spp. Certain conditions predispose individuals to pulmonary aspergilloses, for example, neutropenia, prolonged steroid therapy, immunosuppressive drugs, and solid organ transplants. Individuals are infected with spores by inhalation. CPA is diagnosed through imaging features, such as cavities, fungal balls, peripheral air crescent signs, and the direct visualization of the spp. (microscopy or culture from biopsy) or immunological response to spp. (serum IgG confirms the diagnosis of CPA). All these should be present for at least three months. An infection is uncommon in those with the human immunodeficiency virus (HIV) due to intact phagocytic cell function. However, HIV-infected individuals with CD4+ T cell < 100 cells/mL are more likely to experience disease progression. Chronic tubercular cavities predispose one to the colonization of cavities with spp. When HIV advances to AIDS (acquired immunodeficiency syndrome), the aspergilloma transforms into an invasive form.
慢性肺曲霉病（CPA）由腐生真菌引起。某些情况会使个体易患肺曲霉病，例如中性粒细胞减少、长期使用类固醇治疗、免疫抑制药物以及实体器官移植。个体通过吸入孢子而感染。CPA通过影像学特征进行诊断，如空洞、真菌球、外周空气新月征，以及直接观察到真菌（活检的显微镜检查或培养）或对真菌的免疫反应（血清IgG可确诊CPA）。所有这些表现都应持续至少三个月。由于吞噬细胞功能完好，人类免疫缺陷病毒（HIV）感染者发生曲霉感染并不常见。然而，CD4 + T细胞<100个/毫升的HIV感染者更有可能出现疾病进展。慢性结核空洞易导致曲霉在空洞内定植。当HIV发展为获得性免疫缺陷综合征（AIDS）时，曲菌球会转变为侵袭性形式。
