What do you think?

Aspergillus Disease
False
Respiratory medicine
Aspergillus Disease
Discuss respiratory medicine here
There's something in the air in Tayside - in the last year our diagnosis rate for aspergillus related respiratory illness has doubled.  I'm not sure whether we're looking for more of it, finding
0
Cat:OpenClinicalForum:8114d353-b41b-4a03-b052-dc009589d5cf
Cat:OpenClinicalForum:8114d353-b41b-4a03-b052-dc009589d5cfDiscussion:2779c0b6-a4cd-4a57-b110-36d185bba72d

Forums » Open clinical » Respiratory medicine » Aspergillus Disease

You must be logged in to contribute. Log in | Register
 
Forums  »  Open clinical  »  Respiratory medicine  »  Aspergillus Disease

Aspergillus Disease

posted at 18/4/2012 11:27 PM BST on bmj.com
Posts: 1178
First: 19/4/2010
Last: 21/5/2013
There's something in the air in Tayside - in the last year our diagnosis rate for aspergillus related respiratory illness has doubled.  I'm not sure whether we're looking for more of it, finding more of it, or thether there genuinely is a more out there to find, but it seems real.

Are you finding more aspergillus disease in your practice, or is thiere just a large fungus cloud over Tayside?

Re: Aspergillus Disease

posted at 19/4/2012 1:32 AM BST on bmj.com
Posts: 2947
First: 10/3/2009
Last: 29/4/2013
I have not seen any increase although we don't have the Viking Winds blowing ill fortune up the Tay. 

I have one patient with an aspergilloma from sarcoidosis and one asthmatic with ABPA and see aspergillus in bronchial washings sometimes (no clinical importance).

I have no patient with invasive aspergillosis but my practice would make that unlikely. 

It is an ill wind that brings nobody any good. 

Re: Aspergillus Disease

posted at 20/4/2012 4:47 PM BST on bmj.com
Posts: 3045
First: 27/3/2012
Last: 20/5/2013
Yes, surely the incidence of aspergillosis is rising to an alarming level!

Re: Aspergillus Disease

posted at 23/4/2012 9:18 PM BST on bmj.com
Posts: 1178
First: 19/4/2010
Last: 21/5/2013
Even today, from a clinic of 32 patients, unselected general respiratory medicine, 2 have most likely an aspergillus related illness...

Itraconazole - cheap, but many side effects.
Voriconazole - expensive
Posaconazole - exorbitant....

Re: Aspergillus Disease

posted at 24/4/2012 1:32 AM BST on bmj.com
Posts: 1283
First: 9/12/2011
Last: 21/5/2013
here is a link of interest Dundee

http://clinicaltrials.gov/ct2/show/NCT00263315?term=aspergillosis&rank=1

DuaneF

Re: Aspergillus Disease

posted at 24/4/2012 11:59 AM BST on bmj.com
Posts: 1178
First: 19/4/2010
Last: 21/5/2013
Thanks DuaneF.

We have used amphoteracin B in patients with invasive aspergilllosis, but this generally occurs in the context of immunosuppression, or immunodeficiency.  I have to say that the 2 patients I've given ambisome to for invasive aspergillosis both died in ICU.

The patients with chronic cavitatory aspergillosis are a very difficult bunch to treat - itraconazole is very poorly tolerated, and often doesn't do much, vori and pos are both very expensive.  In my health board we have to apply on an individual patient basis to be able to prescribe the expensive drugs.  I do have some patients on posaconazole, and they're doing well, I have to say....



Forums » Open clinical » Respiratory medicine » Aspergillus Disease