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Hurraß J, Heinzow B, Walser-Reichenbach S, Aurbach U, Becker S, Bellmann R, Bergmann KC, Cornely OA, Engelhart S, Fischer G, Gabrio T, Herr CE, Joest M, Karagiannidis C, Klimek L, Köberle M, Kolk A, Lichtnecker H, Lob-Corzilius T, Mülleneisen N, Nowak D, Rabe U, Raulf M, Steinmann J, Steiß JO, Stemler J, Umpfenbach U, Valtanen K, Werchan B, Willinger B, Wiesmüller GA. AWMF mold guideline "Medical clinical diagnostics for indoor mold exposure" - Update 2023 AWMF Register No. 161/001. Allergol Select 2024; 8:90-198. [PMID: 38756207 PMCID: PMC11097193 DOI: 10.5414/alx02444e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/04/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Julia Hurraß
- Section for Hygiene in Healthcare Facilities, Division of Infection Control and Environmental Hygiene, Cologne Health Department, Cologne
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Birger Heinzow
- Formerly: State Agency for Social Services (LAsD) Schleswig-Holstein, Kiel
- Co-author
| | - Sandra Walser-Reichenbach
- Formerly: State Agency for Social Services (LAsD) Schleswig-Holstein, Kiel
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Ute Aurbach
- Laboratory Dr. Wisplinghoff
- ZfMK – Center for Environment, Hygiene and Mycology Cologne, Cologne
- Co-author
| | - Sven Becker
- Department for Otorhinolaryngology, Head and Neck Surgery, University Medical Center Tübingen, Tübingen, Germany
- Co-author
| | - Romuald Bellmann
- Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
- Co-author
| | - Karl-Christian Bergmann
- Institute of Allergology Charité, Charité – University Medicine Berlin, Berlin
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Oliver A. Cornely
- Institute for Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany and Department I for Internal Medicine, Cologne University Hospital, Cologne
- Co-author
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Guido Fischer
- Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart
- Co-author
| | - Thomas Gabrio
- Formerly: Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart
- Co-author
| | - Caroline E.W. Herr
- Bavarian Health and Food Safety Authority, Munich
- Environmental Health and Prevention, Institute and Polyclinic for Occupational, Social and Environmental Medicine, University of Munich Hospital Ludwig-Maximilians-University, Munich
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Marcus Joest
- Allergological-Immunological Laboratory, Helios Lung and Allergy Center Bonn, Bonn
- Co-author
| | - Christian Karagiannidis
- Faculty of Health, Professorship for Extracorporeal Lung Replacement Procedures, University of Witten/Herdecke, Witten/Herdecke
- Lung Clinic Cologne Merheim, Clinics of the City of Cologne, Cologne
- Co-author
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Martin Köberle
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Annette Kolk
- Institute for Occupational Safety and Health (IFA) of the German Social Accident Insurance (DGUV), Unit Biological Agents, Sankt Augustin
- Co-author
| | - Herbert Lichtnecker
- Medical Institute for Environmental and Occupational Medicine MIU GmbH Erkrath, Erkrath
- Co-author
| | - Thomas Lob-Corzilius
- Scientific working group of environmental medicine of the German Society of Pediatric Allergology (GPAU)
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Norbert Mülleneisen
- Asthma and Allergy Center Leverkusen, Leverkusen
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Dennis Nowak
- Institute and Polyclinic for Occupational, Social and Environmental Medicine, member of the German Center for Lung Research, Hospital of the University of Munich, Munich
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Uta Rabe
- Center for Allergology and Asthma, Johanniter Hospital Treuenbrietzen, Treuenbrietzen
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Statutory Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Jörg Steinmann
- Center for Pediatrics and Adolescent Medicine, University Hospital Giessen and Marburg GmbH, Giessen
- Co-author
| | - Jens-Oliver Steiß
- Specialized Practice in Allergology and Pediatric Pulmonology in Fulda, Fulda
- Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Private Medical University Nuremberg Clinic, Nuremberg
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Jannik Stemler
- Institute for Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany and Department I for Internal Medicine, Cologne University Hospital, Cologne
- Co-author
| | - Ulli Umpfenbach
- Doctor for Pediatrics and Adolescent Medicine, Pediatric Pulmonology, Environmental Medicine, Classical Homeopathy, Asthma Trainer, Neurodermatitis Trainer, Viersen
- Co-author
| | - Kerttu Valtanen
- FG II 1.4 Microbiological Risks, German Environment Agency, Berlin
- Co-author
| | - Barbora Werchan
- German Pollen Information Service Foundation (PID), Berlin, Germany
- Co-author
| | - Birgit Willinger
- Department of Laboratory Medicine, Division of Clinical Microbiology – Medical University of Vienna, Vienna, Austria, and
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Gerhard A. Wiesmüller
- Laboratory Dr. Wisplinghoff
- ZfMK – Center for Environment, Hygiene and Mycology Cologne, Cologne
- Institute for Occupational, Social and Environmental Medicine, Uniclinic RWTH Aachen, Aachen, Germany
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
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Özdemir Ö, Pop S, Mesut Nezir Engin M. COVID-19 in an Allergic Bronchopulmonary Aspergillosis Patient: A Case Report. Turk Arch Pediatr 2022; 56:396-398. [PMID: 35005738 PMCID: PMC8655971 DOI: 10.5152/turkarchpediatr.2021.21073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Öner Özdemir
- Division of Allergy and Immunology, Department of Pediatric, Traning and Research Hospital of Sakarya University School of Medicine, Sakarya, Turkey
| | - Serdar Pop
- Department of Pediatrics, Training and Research Hospital of Sakarya University School of Medicine, Sakarya, Turkey
| | - Muhammet Mesut Nezir Engin
- Department of Pediatrics, Training and Research Hospital of Sakarya University School of Medicine, Sakarya, Turkey
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Ezeokoli OT, Gcilitshana O, Pohl CH. Risk Factors for Fungal Co-Infections in Critically Ill COVID-19 Patients, with a Focus on Immunosuppressants. J Fungi (Basel) 2021; 7:545. [PMID: 34356924 PMCID: PMC8304654 DOI: 10.3390/jof7070545] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/15/2022] Open
Abstract
Severe cases of coronavirus disease 2019 (COVID-19) managed in the intensive care unit are prone to complications, including secondary infections with opportunistic fungal pathogens. Systemic fungal co-infections in hospitalized COVID-19 patients may exacerbate COVID-19 disease severity, hamper treatment effectiveness and increase mortality. Here, we reiterate the role of fungal co-infections in exacerbating COVID-19 disease severity as well as highlight emerging trends related to fungal disease burden in COVID-19 patients. Furthermore, we provide perspectives on the risk factors for fungal co-infections in hospitalized COVID-19 patients and highlight the potential role of prolonged immunomodulatory treatments in driving fungal co-infections, including COVID-19-associated pulmonary aspergillosis (CAPA), COVID-19-associated candidiasis (CAC) and mucormycosis. We reiterate the need for early diagnosis of suspected COVID-19-associated systemic mycoses in the hospital setting.
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Affiliation(s)
| | | | - Carolina H. Pohl
- Yeast Research Group, Department of Microbiology and Biochemistry, University of the Free State, Bloemfontein 9300, South Africa or (O.T.E.); (O.G.)
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Snen H, Kallel A, Blibech H, Jemel S, Salah NB, Marouen S, Mehiri N, Belhaj S, Louzir B, Kallel K. Case Report: Allergic Bronchopulmonary Aspergillosis Revealing Asthma. Front Immunol 2021; 12:695954. [PMID: 34239516 PMCID: PMC8259593 DOI: 10.3389/fimmu.2021.695954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/08/2021] [Indexed: 01/26/2023] Open
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is an immunological pulmonary disorder caused by hypersensitivity to Aspergillus which colonizes the airways of patients with asthma and cystic fibrosis. Its diagnosis could be difficult in some cases due to atypical presentations especially when there is no medical history of asthma. Treatment of ABPA is frequently associated to side effects but cumulated drug toxicity due to different molecules is rarely reported. An accurate choice among the different available molecules and effective on ABPA is crucial. We report a case of ABPA in a woman without a known history of asthma. She presented an acute bronchitis with wheezing dyspnea leading to an acute respiratory failure. She was hospitalized in the intensive care unit. The bronchoscopy revealed a complete obstruction of the left primary bronchus by a sticky greenish material. The culture of this material isolated Aspergillus fumigatus and that of bronchial aspiration fluid isolated Pseudomonas aeruginosa. The diagnosis of ABPA was based on elevated eosinophil count, the presence of specific IgE and IgG against Aspergillus fumigatus and left segmental collapse on chest computed tomography. The patient received an inhaled treatment for her asthma and a high dose of oral corticosteroids for ABPA. Her symptoms improved but during the decrease of corticosteroids, the patient presented a relapse. She received itraconazole in addition to corticosteroids. Four months later, she presented a drug-induced hepatitis due to itraconazole which was immediately stopped. During the monitoring of her asthma which was partially controlled, the patient presented an aseptic osteonecrosis of both femoral heads that required surgery. Nine months after itraconazole discontinuation, she presented a second relapse of her ABPA. She received voriconazole for nine months associated with a low dose of systemic corticosteroid therapy with an improvement of her symptoms. After discontinuation of antifungal treatment, there was no relapse for one year follow-up.
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Affiliation(s)
- Houda Snen
- Pulmonary Department, Hospital Mongi Slim, La Marsa, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Aicha Kallel
- Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Parasitology and Mycology Department, La Rabta Hospital, Tunis, Tunisia
| | - Hana Blibech
- Pulmonary Department, Hospital Mongi Slim, La Marsa, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Sana Jemel
- Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Parasitology and Mycology Department, La Rabta Hospital, Tunis, Tunisia
| | - Nozha Ben Salah
- Pulmonary Department, Hospital Mongi Slim, La Marsa, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Sonia Marouen
- Parasitology and Mycology Department, La Rabta Hospital, Tunis, Tunisia
| | - Nadia Mehiri
- Pulmonary Department, Hospital Mongi Slim, La Marsa, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Slah Belhaj
- Parasitology and Mycology Department, La Rabta Hospital, Tunis, Tunisia
| | - Bechir Louzir
- Pulmonary Department, Hospital Mongi Slim, La Marsa, Tunisia.,Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia
| | - Kalthoum Kallel
- Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.,Parasitology and Mycology Department, La Rabta Hospital, Tunis, Tunisia
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Acosta-Rivera V, Melendez-Montañez JM, De Jesús-Rojas W. Allergic Bronchopulmonary Aspergillosis With or Without Asthmatic Symptoms? Cureus 2021; 13:e15498. [PMID: 34268029 PMCID: PMC8262577 DOI: 10.7759/cureus.15498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/05/2022] Open
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a localized inflammatory airway disease seen in patients sensitized to Aspergillus fumigatus (A. fumigatus) antigens. The disease presents with productive cough, wheezing, episodic fever, as well as central bronchiectasis (CB) and mucus plugs on computed tomography (CT) scans. If treated accordingly, symptoms and pulmonary damage caused by ABPA can be reverted. Currently, the diagnostic criteria for ABPA require the diagnosis of predisposing pulmonary diseases such as asthma and cystic fibrosis (CF) in order to establish the diagnosis. There has been an increasing number of cases reporting ABPA without evidence of past asthmatic history or symptoms. This reflects the need for more sensitive diagnostic tests in order to prevent progression to irreversible lung injury. Here we report a 22-year-old Puerto Rican male who went undiagnosed for ABPA for 12 months due to the absence of asthma or CF history.
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Affiliation(s)
| | - Jesus M Melendez-Montañez
- Biology, University of Puerto Rico, Mayagüez Campus, Mayagüez, PRI.,Medicine, Ponce Health Sciences University, Ponce, PRI
| | - Wilfredo De Jesús-Rojas
- Pediatrics, Ponce Health Science University, Ponce, PRI.,Pediatrics, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
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