@entity20585 ( @entity20585 ) is an uncommon and problematic @entity358 , complicating many other @entity1576 , thought to affect ~240 000 @entity1 in Europe. The most common form of @entity20585 is chronic @entity57 (CCPA), which untreated may progress to chronic fibrosing @entity57 . Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised @entity1 with prior or current @entity358 . Subacute invasive @entity57 (formerly called chronic @entity4685 @entity57 ) is a more rapidly progressive @entity281 (<3 months) usually found in moderately immunocompromised @entity1 , which should be managed as @entity3 . Few clinical guidelines have been previously proposed for either diagnosis or management of @entity20585 . A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of @entity20585 requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of @entity281 (microscopy or culture from biopsy) or an immunological response to Aspergillus spp. and exclusion of alternative diagnoses, all present for at least 3 months. Aspergillus antibody (precipitins) is elevated in over 90% of @entity1 . Surgical excision of @entity1538 is recommended, if technically possible, and preferably via video-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, @entity1167 and prevent progression. Careful monitoring of @entity5638 serum concentrations, drug interactions and possible @entity137 is recommended. Haemoptysis may be controlled with @entity927 and @entity2488 , rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. @entity1 with single Aspergillus nodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up.

XXXX : rationale and clinical guidelines for diagnosis and management.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'people'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicities'] @entity57 :: ('MESH:D055732', 'Disease') :: ['pulmonary aspergillosis', 'cavitary pulmonary aspergillosis'] @entity1538 :: ('MESH:D005902', 'Disease') :: ['simple aspergilloma'] @entity2488 :: ('MESH:D001982', 'Disease') :: ['bronchial artery embolisation'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection', 'Aspergillus infection'] @entity358 :: ('MESH:D008171', 'Disease') :: ['lung disease', 'pulmonary disease'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory disorders'] @entity3 :: ('MESH:D009362', 'Disease') :: ['invasive aspergillosis'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['arrest haemoptysis'] @entity927 :: ('MESH:D014148', 'Chemical') :: ['tranexamic acid'] @entity20585 :: ('MESH:D055744', 'Disease') :: ['Chronic pulmonary aspergillosis', 'CPA'] @entity5638 :: ('CHEBI:68452', 'Chemical') :: ['azole'] @entity4685 :: ('MESH:D009187', 'Disease') :: ['necrotising']
@entity20585 :: (MESH:D055744,Disease) :: ['Chronic pulmonary aspergillosis']
