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Erschienen in: Allergo Journal 4/2024

10.06.2024 | Aspergillus-Mykosen | Übersicht

Aspergillus-assoziierte Erkrankungen aus infektiologischer und allergologischer Perspektive

verfasst von: Jannik Stemler, Julia A. Nacov, Rosanne Sprute, Oliver A. Cornely, Dr. med. Marcus Joest, PD Dr. med. Sven Becker, Prof. Dr. med. Ludger Klimek

Erschienen in: Allergo Journal | Ausgabe 4/2024

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Zusammenfassung

Aspergillus-assoziierte Erkrankungen sind selten und stellen Behandler vor Herausforderungen. Die Diagnosestellung ist komplex und erfordert rationale, gezielte und multidisziplinäre Zusammenarbeit, sowie einen hohen Grad an Expertise und ein individuelles Vorgehen.
In der Infektiologie steht die Frage nach Infektion oder Kolonisation im Vordergrund. Bei schwer immunsupprimierten Patienten tritt die invasive Aspergillose auf, welche am häufigsten die Lunge betrifft (IPA) und durch ein invasives, destruierendes Wachstum gekennzeichnet ist. Dieses akute Krankheitsbild geht mit einer hohen Mortalität einher.
Die chronisch pulmonale Aspergillose (CPA) entsteht auf dem Boden einer vorbestehenden Lungenstrukturveränderung durch andere pulmonale Erkrankungen und muss nicht selten auch chirurgisch saniert werden.
Eine weitere chronische Verlaufsform ist die allergische bronchopulmonale Aspergillose (ABPA). Sie ist häufig mit Bronchiektasen bei Patienten mit Asthma bronchiale oder zystischer Fibrose vergesellschaftet.
Bei Sinusmykosen unterscheidet man die nicht invasive und invasive Form, welche bei immungeschwächten Patienten vorkommen kann und am häufigsten die Kieferhöhle betrifft. Hier sind lokale chirurgische Maßnahmen obligater Teil der Therapie, wohingegen bei der nicht invasiven Form meist eine allergische Komponente vorliegt.
Zudem kommt bei allen Entitäten eine medikamentöse antimykotische und/oder antiinflammatorische Therapie zum Einsatz.
Zitierweise: Stemler J, Nacov JA, Sprute R, Cornely OA, Joest M, Becker S, Klimek L. Aspergillus-associated diseases from an infectious diseases and allergological perspective. Allergo J Int 2024;33:140-52
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Metadaten
Titel
Aspergillus-assoziierte Erkrankungen aus infektiologischer und allergologischer Perspektive
verfasst von
Jannik Stemler
Julia A. Nacov
Rosanne Sprute
Oliver A. Cornely
Dr. med. Marcus Joest
PD Dr. med. Sven Becker
Prof. Dr. med. Ludger Klimek
Publikationsdatum
10.06.2024
Verlag
Springer Medizin
Erschienen in
Allergo Journal / Ausgabe 4/2024
Print ISSN: 0941-8849
Elektronische ISSN: 2195-6405
DOI
https://doi.org/10.1007/s15007-024-6283-4

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