"Typically patients present with progressive respiratory and constitutional symptoms (often for few months) including fever, weight loss, cough, sputum production and haemoptysis 2-3."
"Radiographic appearance varies according to when the condition is imaged. It typically involves the upper zones and begins as a pulmonary opacity. Eventually, the central necrotic area separates away from the surrounding lung and thus forms an air crescent sign. This occurs in weeks to months, eventually resulting in a cavity with or without a central mycetoma 3. Appearances may then be the same as an aspergilloma. Often there are multiple cavities, often thick-walled 2. Adjacent pleural thickening is often present 2-3."
"Prognosis is largely dictated by underlying lung disease and co-morbidities with mortality ranging from < 10% to 39% depending on criteria for diagnosis and treatment administered 3."
"Although the end result in this form is similar to an aspergilloma, it represents a different process. Rather than Aspergillus colonising a pre-existing cavity, in CNA a focally invasive aspergillosis occurs which eventually undergoes central necrosis and cavitation forming its own cavity. It is the finding of tissue invasion that allows this entity to be distinguished from the more common aspergilloma 2,5."
"The presence of calcium oxalate crystals suggests that Aspergillus niger is the causative agent 3."
"The vast majority of patients have positive serum immunoglobulins (Ig)G antibodies to A. fumigatus 7."
"During initial phases of the disease, antifungals are the mainstay of treatment. Intravenous and intracavitary amphotericin B, 5-flucytosine (5-FC) and itraconazole have all been tried 3."
Expected headings
"Serological markers"
"malignancy (e.g. cavitating squamous cell carcinoma)"