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Pulmonary Aspergillosis

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There are three possible mode that Aspergillus could act as a disease agent, namely as a toxigenic, allergenic or pathogenic agent. Aspergillus as a toxigenic agent could not be applied in aspergillosis of the lung as the lesion are confined to the lungs while aflatoxin, which is produced by Aspergillus in agricultural products, will incuce hepatoma if ingested adequately. To differentiate whether Aspergillus act as an allergenic or pathogenic agent, detection of specific immunoglobulin against Aspergillus and biopsy of the lung should be carried out. These diagnostic procedures, however, may not be cost effective or could not be done for practical reseasons. Detection of Aspergillus in sputum or bronchial washing and serological examination may help determine whether Aspergillus play a part in the development of the clinical signs and symptoms. To reach the diagnosis of aspergillosis of the lung there should be 1) awareness of the possibility of the disease, 2) knowledge of collection and sending of clinical specimens, 3) expertise in the examination of the clinical specimens by the laboratory technicians and 4) expertise in serological examination. Confirmation of the possible diagnosis may be difficult if there is no mycology laboratory in the hospital or within reasonable distance from the hospital. Generally no mycological examinations were taken into account and mycoses were more often detected by chance during pathological examination. The Mycology Section of the Department of Parasitology, Faculty of Medicine University of Indonesia is one of the few mycology laboratories that isolates and identifies fungi, does serology and examines pathological slides for the possibility of mycotic infection. This paper reports the diagnosis and management of aspergillosis of the lung cases referred to the Mycology Section of the Department of Parasitology, Faculty of Medicine University of Indonesia, which in essence were most of the cases found so far in Indonesia.

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Medical Journal of Indonesia,5(4)1996:185-188

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: ., 1996

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Subject(s)

aspergillosis
lung diseases, fungal

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