7th AAA: Session Five: Host Response

A patient describes his life with chronic pulmonary aspergillosis

Woodrow Maitland tells of his personal experience of having aspergillosis. Like most people he had never heard of aspergillosis when he was finally diagnosed and treated at the National Aspergillosis Centre, Manchester, UK

A series of nasal endoscopies – before during and after surgery. 2. Surgical endoscopy

A series of nasal endoscopies – before during and after surgery. Surgical endoscopy by Raphaella Migliavacca. A patient 12 years old with AML undergoes remission following chemotherapy (2 rounds), admitted several months later with high fever and neutropenia. Patient undergoes regime of antifungal therapy including fluconazole, AmpB and voriconazole. (see full case as powerpoint slides presented In Brazil In FocusVII Aug 2009 Raphaella Migliavacca.). Nasal endoscopy was performed both pre-operatively and surgery removed a fungal ball. Biopsy revealed suppurative acute inflammatory findings (middle turbinate) and angioinvasive fungal structures consistent with aspergillosis. Cultures revealed Aspergillus flavus. Eight weeks later another endoscopy post surgery revealed marked improvement and reduced inflammation. The patient was given 12 weeks voriconazole followinf the surgery, followed by 3rd chemotherapy. The patient had recovered and was in complete remission 4 months after the surgical endoscopy.

A series of nasal endoscopies – before during and after surgery. 1. Pre-operative endoscopy

Pre-operative endoscopy by Raphaella Migliavacca.

A fine needle biopsy of the lung

Produced by David Denning and described by Dr Rob Bissett. With kind permission of Gardiner-Caldwell, funded by Janssen-Cilag. Copyright Aspergillus Website.

A nasal endoscopy of a patient with a CSF leak

This patient had a small hole in the bone at the base of the skull. He underwent endoscopy through the nose which shows the defect in the skull through which the brain is visible (pulsating). Kindly provided by Hesham Saleh, Consultant Rhinologist, Charing Cross and Royal Brompton Hospital .

Endoscopic examination of Aspergillus ear infection: A collection

The Aspergillus Website maintains a collection of clinical videos published on Youtube. Click on the listing at the top to access all videos.

A normal endoscopy through the nose

Kindly provided by Hesham Saleh, Consultant Rhinologist, Charing Cross and Royal Brompton Hospital

Endoscopic Treatment of Allergic Fungal Maxillary Sinusitis

Removing fungal growth from the maxillary sinus via the use of an endoscope.

Removal of fungal ball from maxillary sinus

This video shows the removal of the fungal ball through the left nasal passage

The removal of a fungal ball from the lung

Produced by Dr Mark Jones and David Denning. Copyright Aspergillus Website.