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AR-12 For further details go to the new antifungal drugs section AR-12 (Antitumor/Antifungal Celecoxib Derivative)
AR-12 (Antitumor/Antifungal Celecoxib Derivative) AR-12 For further details go to the new antifungal drugs section
Tipifarnib Farnesyltransferase inhibitor - see new Antifungal drugs section for more details Tipifarnib (farnesyltransferase inhibitor)
Tipifarnib (farnesyltransferase inhibitor) Tipifarnib Farnesyltransferase inhibitor - see new Antifungal drugs section for more details
Manumycin A Farnesyltransferase inhibitor - see New Antifungal drugs section for more details Manumycin A (farnesyltransferase inhibitor)
Manumycin A (farnesyltransferase inhibitor) Manumycin A Farnesyltransferase inhibitor - see New Antifungal drugs section for more details
Case 66: Aspergillus invasive skin graft infection in a child suffering from severe burns. Figure 1. Case history number 66
Piles of Rotting Woodchip A pile of woodchip stored for use in a garden usually as a weed suppressing mulch. The heat building up in the pile is illustrated by the plumes of steam eminating from the top of the pile.Aspergillus fumigatus is particularly well adapted to grow read more... Image 1, Image 2, Image 3, Image 4. Note visible mould growth.
Image 1, Image 2, Image 3, Image 4. Note visible mould growth. Piles of Rotting Woodchip A pile of woodchip stored for use in a garden usually as a weed suppressing mulch. The heat building up in the pile is illustrated by the plumes of steam eminating from the top of the pile.Aspergillus fumigatus is particularly well adapted to grow read more...
Aspergillus bronchitis and mucoid impaction: PtMK MK is 59 years old and presented with right sided pleuritic chest pain and coughing over 1 week. A chest Xray and then CT scan revealed complete collapse of her right lower lobe and middle lobes. Mucous retention is seen just proximal to the abrupt read more... October 2016, January 2017
October 2016, January 2017 Aspergillus bronchitis and mucoid impaction: PtMK MK is 59 years old and presented with right sided pleuritic chest pain and coughing over 1 week. A chest Xray and then CT scan revealed complete collapse of her right lower lobe and middle lobes. Mucous retention is seen just proximal to the abrupt read more...

A bronchoscopy found large amounts of mucous that was suctioned and removed. Aspergillus was found in the mucous on microscopy and A. fumigatus grown in culture. 

She felt better immediately and a follow up scan shows re-expansion of the right middle and lower lobes. 

A diagnosis of Aspergillus bronchitis was made based on the bronchoscopy findings, microscopy and culture results and supported by an positive Aspergillus IgG of 97mg/L (ImmunoCap). 

Papular rash with CPA Drug rashes: Drug interactions between steroids and anti-fungal drugs - (ecchymosis) Image A: Red skin rash on arms due to effect of inhaled steroids termed ecchymosis., Image B: Red skin rash on arms due to effect of inhaled steroids termed ecchymosis., Image C: Papular rash with blisters on the back, associated with CPA but prior to treatment, rash appeared 2 years previously in October 2007. The rash resolved on treatment with azoles., Image D: Papular rash with blisters on the back, associated with CPA but prior to treatment, rash appeared 2 years previously in October 2007. The rash resolved on treatment with azoles.
Image A: Red skin rash on arms due to effect of inhaled steroids termed ecchymosis., Image B: Red skin rash on arms due to effect of inhaled steroids termed ecchymosis., Image C: Papular rash with blisters on the back, associated with CPA but prior to treatment, rash appeared 2 years previously in October 2007. The rash resolved on treatment with azoles., Image D: Papular rash with blisters on the back, associated with CPA but prior to treatment, rash appeared 2 years previously in October 2007. The rash resolved on treatment with azoles. Papular rash with CPA Drug rashes: Drug interactions between steroids and anti-fungal drugs - (ecchymosis)
Facial erythema: Side effects of anti-fungal drugs - drug rashes Reference: Muco-cutaneous retinoid effects and facial erythema related to the novel triazole antifungal agent voriconazole. Denning, DW & Griffiths, CEM. Clin.Exp Dermatol 2001, 26(8), 648-53.Courtesy of Dr D Denning, Wythenshawe Hospital, read more... Patient AB: Voriconazole rash. Following 8 weeks of Voriconazole, patient had remarkable facial erythema, most consistent with sun exposure because of sparing of her neck., Patient AB: Voriconazole rash. Following 8 weeks of Voriconazole, patient had remarkable facial erythema, most consistent with sun exposure because of sparing of her neck., Patient AB: Discoid lupus erythematosus following 12 months voriconazole therapy. This improved with use of sunblock factor 30 and resolved after discontinuation of voriconazole, 2 months later.
Patient AB: Voriconazole rash. Following 8 weeks of Voriconazole, patient had remarkable facial erythema, most consistent with sun exposure because of sparing of her neck., Patient AB: Voriconazole rash. Following 8 weeks of Voriconazole, patient had remarkable facial erythema, most consistent with sun exposure because of sparing of her neck., Patient AB: Discoid lupus erythematosus following 12 months voriconazole therapy. This improved with use of sunblock factor 30 and resolved after discontinuation of voriconazole, 2 months later. Facial erythema: Side effects of anti-fungal drugs - drug rashes Reference: Muco-cutaneous retinoid effects and facial erythema related to the novel triazole antifungal agent voriconazole. Denning, DW & Griffiths, CEM. Clin.Exp Dermatol 2001, 26(8), 648-53.Courtesy of Dr D Denning, Wythenshawe Hospital, read more...
Cresemba Cresemba (Isavuconazole)
Germinating spores of Aspergillus fumigatus Germinating spores of Aspergillus fumigatus
Germinating spores of Aspergillus fumigatus Germinating spores of Aspergillus fumigatus

Scanning Electron Micrograph of germinating Aspergillus fumigatus spores (provided by KM Lord and ND Read)

Aspergillus niger Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation. A niger conidial head TEM in vitro, A niger mature conidium TEM in vitro
A niger conidial head TEM in vitro, A niger mature conidium TEM in vitro Aspergillus niger Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
Aspergillus terreus Micrographs of A. terreus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation. A terreus aleurospore TEM in vitro, A terreus mature conidium SEM in vitro, A terreus mature conidial head SEM in vitro
A terreus aleurospore TEM in vitro, A terreus mature conidium SEM in vitro, A terreus mature conidial head SEM in vitro Aspergillus terreus Micrographs of A. terreus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
Electron Microscopy: Aspergillus fumigatus Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation. Conidial head (SEM), Part of conidial head (SEM), Mature conidia (SEM), Hyphae (SEM), Murine lung tissue (TEM)
Conidial head (SEM), Part of conidial head (SEM), Mature conidia (SEM), Hyphae (SEM), Murine lung tissue (TEM) Electron Microscopy: Aspergillus fumigatus Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
Aspergillus clavatus Isolate from environmental sample A. clavatus, A. clavatus, A. clavatus
A. clavatus, A. clavatus, A. clavatus Aspergillus clavatus Isolate from environmental sample
ABPA complicated by severe varicose bronchiectasis Patients has history of ABPA complicating long standing asthma. His total IgE has fluctuated between 2,200 and 4,600 KU/L, his Aspergillus IgE between 36.3 and 65.4 kAU/L and Aspergillus IgG from 87-154 mg/L. He has been taking long term read more... December 2012, May 2012, December 2012, February 2010
December 2012, May 2012, December 2012, February 2010 ABPA complicated by severe varicose bronchiectasis Patients has history of ABPA complicating long standing asthma. His total IgE has fluctuated between 2,200 and 4,600 KU/L, his Aspergillus IgE between 36.3 and 65.4 kAU/L and Aspergillus IgG from 87-154 mg/L. He has been taking long term read more...

The CT scan (3 cuts from the same scan in 2012) shows background  paraseptal  and  centrilobular  emphysema  and  the  distribution  of  the  varicoid  bronchiectasis (i.e. upper lobe predominant and central)  is  consistent  with  ABPA.  There  are no  areas  of  consolidation  or  evidence  of  interstitial  lung  disease.  Several fluid  levels  are seen within  the  airways  together with bronchial  wall  thickening   throughout  the  right  hemithorax. There  is  almost  no evidence  of  exudative  small  airways  disease  (i.e.  no  small  airway  impaction).

The chest Xrays show mild  cardiomegaly.  There are  background  chronic  interstitial  changes  of  a  coarsened  reticulonodular  pattern,  with  an  area  of more  prominent  pulmonary  fibrotic  change  in  the  right  mid  zone.    Minor apical thickening noted.   

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