Many may be familiar with aspergillosis as the infecting agent in acute cases where the patient is severely immunocompromised - but there is more to this fungus' repertoire. There are rare cases where the patient's immune system is overwhelmed by a large inhalation of spores e.g. after gardening, but these are insignificant in terms of total numbers effected. The following are far more common:- Aspergillus and other fungi are increasingly identified as the active agent in sinusitis - if you have cases that don't respond to antibiotics this is worth thinking about. Chronic pulmonary aspergillosis (CPA & aspergilloma) is an infection of immunocompetent people, causing respiratory difficulty, coughing and haemoptysis. The UK NHS has a specialist centre for these patients In Manchester (National Aspergillosis Centre (NAC)). NAC has particular expertise and extensive facilities for the diagnosis of CPA, ABPA, SAFS and use of systemic antifungal drugs. Allergic infection (Allergic Bronchopulmonary Aspergillosis - ABPA and chronic sinusitis) is thought to be heavily underdiagnosed and undertreated. ABPA is particularly common in Asthma, Cystic Fibrosis patients and those with bronchiectasis. There is estimated to be 25 000 cases in the UK alone. Many (50%) of the most severe asthma cases are sensitive to fungi (SAFS) - in particular Aspergillus. These tend to be the most unstable cases that don't respond to antibiotics and several studies have been published that show giving an antifungal helps reduce the use of steroids for these patients. Last but not least - Tuberculosis is on the rise in the UK and the rest of the world. It is estimated that 2% of cases progress to CPA and should be treated using an antifungal - this is usually not done until considerable time has passed and much damage has been done. In total it is estimated that many millions of people across the world suffer from aspergillus - ABPA - 5 million, Tb - 400 000 per year and Asthma (SAFS - 1 - 4 million cases in EU & US). Sinusitis cases may number many tens of millions worldwide. So - the next time you assume aspergillus infections and aspergillosis are rare and confined to those who are profoundly immunocompromised - think again! If you have a patient who has increasingly severe respiratory symptoms, doesn't respond to multiple courses of antibiotics then give aspergillus a thought. Browse around these articles for further information Aspergillus Website Treatment Section. NB For a broader look at the prevalence of fungal diseases worldwide the new charity Leading International Fungal Education (LIFE) website is worth looking at.
almost 9 years ago
The anesthetists loves magnesium. But when I asked of the mechanism from A&E consultants, I got replies that it is wonder drug, or not well understood. Anyone got a more comprehensive answer than that?
about 9 years ago
I heard that more people are being diagnosed with alleges, such as nut allergies. Is there any really understanding of why this is?
about 9 years ago
A short, 16-slide presentation on the topic of immunologically-mediated food allergies, both IgE and call mediated types. Covers the epidemiology, aetiology, pathophysiology, presentation, history/investigations and management.
about 9 years ago
This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates how to use a nebuliser and explain correct inhaler technique to a patient. It is part of a series of videos covering Respiratory Medicine skills.
over 9 years ago
This is a diagram I created to summarise the immune response, complete with friendly, loveable cartoon immune cells designed in an attempt to make what can be a very complicated and confusing subject seem a little less threatening. The students I taught the subject to loved the "cute" summary format and found immunology to be a much more approachable revision topic as a result! Since this image has been so popular with all you lovely people, I have also written a comprehensive article on the immune response - complete with lots of illustrations - which is available here on Geeky Medics: http://geekymedics.com/2014/07/02/immune-response/ Enjoy and good luck!
Miss Laura Jayne Watson
over 9 years ago
This session was designed to teach first year medical students about allergies and the basic medical management of anaphylaxis. The session was student led with a tutor in the audience to help provoke discussion and encourage students to participate. The session utilised an interactive smart-board with touch-screen function in order to get students involved in learning. Although the information is not overly complex it is a good introduction to the topic and promoted student involvement as well as group interaction and teamwork.
over 10 years ago
An interactive learning resource that explores the life cycle of the Schistosoma mansoni parasite and how it exploits the human immune system in order to survive. All links are back up and running. Please let me know if you experience any diffuclties. Thank you!
almost 11 years ago
ResearchToPractice.com/MTPH109 – Case 2 from the practice of Gracy Joshua, MD presented to Drs Gregory and Orlowski, moderated by Neil Love, MD. A woman in her early sixties with follicular lymphoma and a prior history of severe allergic reaction to rituximab experienced a complete remission with bendamustine/rituximab after disease progression on prior treatments with COP, fludarabine and single-agent rituximab. Produced by Research To Practice.
Dr Neil Love
over 11 years ago