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Radiology, Bronchoscopy and Microbiology in Bronchopulmonary Aspergillosis
Radiología, broncoscopia y microbiología de la aspergilosis bronco-pulmonar
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Provocando atelectasia parcial del parénquima dependiente de estos bronquios lobares (flecha blanca). También se objetivaron bronquiectasias varicoides bilaterales en la grabación de parénquima; c) Imagen broncoscópica del tapón mucoso protruyendo desde el bronquio fuente derecho justo antes de ser aspirado; d) Colonias de <span class="elsevierStyleItalic">Aspergillus terreus</span> aisladas en agar Sabouraud-cloranfenicol, con su característico aspecto blancas y algodonosas que se tornan pulverulentas o granulares de color canela-café.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco M. Páez Codeso, María Pilar Bermúdez Ruiz, Antonio Dorado Galindo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Francisco M." 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(B) Chest CT coronal image of the scan of the (pulmonary parenchymal window) from 2014, showing the appearance of 2 nodules in the right lung: one solid (arrow) and other subsolid with mainly ground glass attenuation and a small, solid core (asterisk). (C) Chest CT axial image (pulmonary parenchymal window) from 2016 showing the appearance of 2 cavitary lung nodules in the right pulmonary apex (arrows). Note that the most lateral nodule has non-centered cavitation with half-moon morphology. (D) Chest CT axial image (mediastinal window) from 2017 in which linear calcification (arrow) has appeared within a solid nodule in the middle lobe.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Gorospe Sarasúa, Gemma María Muñoz-Molina, Paola Arrieta" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" ] 1 => array:2 [ "nombre" => "Gemma María" "apellidos" => "Muñoz-Molina" ] 2 => array:2 [ "nombre" => "Paola" "apellidos" => "Arrieta" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289618302102" "doi" => "10.1016/j.arbres.2018.05.020" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618302102?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918303379?idApp=UINPBA00003Z" "url" => "/15792129/0000005400000012/v1_201812020625/S1579212918303379/v1_201812020625/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212918303902" "issn" => "15792129" "doi" => "10.1016/j.arbr.2018.06.014" "estado" => "S300" "fechaPublicacion" => "2018-12-01" "aid" => "1940" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2018;54:619-24" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 577 "formatos" => array:3 [ "EPUB" => 82 "HTML" => 373 "PDF" => 122 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "A New Modality for the Diagnosis of Bleomycin-induced Toxicity: Ultrasonography" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "619" "paginaFinal" => "624" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nuevo método diagnóstico para la toxicidad inducida por bleomicina: la ecografía" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 618 "Ancho" => 1700 "Tamanyo" => 171664 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Predefined anatomic lines (1—linea mid-clavicularis, 2—linea axillaris anterior, 3—linea axillaris media, 4—linea axillaris posterior, 5—linea scapularis, 6—linea para vertebralis).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Coşkun Doğan, Sevda Şener Cömert, Benan Çağlayan, Seda Beyhan Sağmen, Elif Torun Parmaksız, Nesrin Kıral, Ali Fidan, Banu Salepçi" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Coşkun" "apellidos" => "Doğan" ] 1 => array:2 [ "nombre" => "Sevda Şener" "apellidos" => "Cömert" ] 2 => array:2 [ "nombre" => "Benan" "apellidos" => "Çağlayan" ] 3 => array:2 [ "nombre" => "Seda Beyhan" "apellidos" => "Sağmen" ] 4 => array:2 [ "nombre" => "Elif Torun" "apellidos" => "Parmaksız" ] 5 => array:2 [ "nombre" => "Nesrin" "apellidos" => "Kıral" ] 6 => array:2 [ "nombre" => "Ali" "apellidos" => "Fidan" ] 7 => array:2 [ "nombre" => "Banu" "apellidos" => "Salepçi" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0300289618302710" "doi" => "10.1016/j.arbres.2018.06.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618302710?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918303902?idApp=UINPBA00003Z" "url" => "/15792129/0000005400000012/v1_201812020625/S1579212918303902/v1_201812020625/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Radiology, Bronchoscopy and Microbiology in Bronchopulmonary Aspergillosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "625" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco M. Páez Codeso, María Pilar Bermúdez Ruiz, Antonio Dorado Galindo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Francisco M." "apellidos" => "Páez Codeso" "email" => array:1 [ 0 => "paezco64@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María Pilar" "apellidos" => "Bermúdez Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Antonio" "apellidos" => "Dorado Galindo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Regional de Málaga, Málaga, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Microbiología, Hospital Regional de Málaga, Málaga, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Radiología, broncoscopia y microbiología de la aspergilosis bronco-pulmonar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1293 "Ancho" => 1583 "Tamanyo" => 242150 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a and b) Coronal and axial computed tomography images, showing high density material in the mediastinum (corresponding to the mucous plug) in almost all of the bronchial tree, with partial occupation starting at the entrance to the main bronchus, complete occupation of the intermediate bronchus, and complete occlusion of the lower and middle lobe bronchi (black arrows), causing partial atelectasis of the parenchyma dependent on these lobar bronchi (white arrow). Bilateral varicose bronchiectasis were also observed in the parenchymal images. (c) Bronchoscopic image of the mucous plug protruding from the entrance to the right bronchus just before aspiration. (d) Characteristic white, cottony <span class="elsevierStyleItalic">Aspergillus terreus</span> colonies isolated in Sabouraud chloramphenicol agar, that develop into cinnamon or coffee-colored powder or granules.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 52-year-old woman with a history of 3 episodes of pneumonia and asthma. She consulted due to dyspnea, chronic cough, and low-grade fever. Clinical laboratory tests showed eosinophilia 7.7% (0.5×10<span class="elsevierStyleSup">9</span>/l) and total immunoglobulin E (IgE<span class="elsevierStyleInf">T</span>): 6680<span class="elsevierStyleHsp" style=""></span>IU/l. Skin prick and radioallergosorbent (RAST) tests were positive for <span class="elsevierStyleItalic">Aspergillus</span>. Computed tomography images are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a and b. Bronchoscopy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>c) revealed a large, thick, purulent mucous plug in the entrance to the right pulmonary tree. Bronchial aspirate fluid showed fungal mycelia and <span class="elsevierStyleItalic">Aspergillus terreus</span> was isolated on culture (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>d). Cytology revealed inflammatory cells and fungal structures consistent with hyphae.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Allergic bronchopulmonary aspergillosis (ABPA) occurs in susceptible patients who are exposed to <span class="elsevierStyleItalic">Aspergillus</span> spores. ABPA affects severe asthmatics and, particularly, patients with cystic fibrosis. Diagnostic criteria do not always present simultaneously.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> In cases such as ours, in which asthma and bronchiectasis coexist, aspergillosis should be considered in the differential diagnosis.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> ABPA is currently subdivided into 2 different subgroups, with and without bronchiectasis. Criteria for ABPA-bronchiectasis are asthma, proximal bronchiectasis, raised IgE<span class="elsevierStyleInf">T</span>, positive skin test for <span class="elsevierStyleItalic">Aspergillus</span> spp, and raised specific IgE and/or IgG in serum.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Páez Codeso FM, Bermúdez Ruiz MP, Dorado Galindo A. Radiología, broncoscopia y microbiología de la aspergilosis bronco-pulmonar. Arch Bronconeumol. 2018;54:625.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1293 "Ancho" => 1583 "Tamanyo" => 242150 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a and b) Coronal and axial computed tomography images, showing high density material in the mediastinum (corresponding to the mucous plug) in almost all of the bronchial tree, with partial occupation starting at the entrance to the main bronchus, complete occupation of the intermediate bronchus, and complete occlusion of the lower and middle lobe bronchi (black arrows), causing partial atelectasis of the parenchyma dependent on these lobar bronchi (white arrow). Bilateral varicose bronchiectasis were also observed in the parenchymal images. (c) Bronchoscopic image of the mucous plug protruding from the entrance to the right bronchus just before aspiration. (d) Characteristic white, cottony <span class="elsevierStyleItalic">Aspergillus terreus</span> colonies isolated in Sabouraud chloramphenicol agar, that develop into cinnamon or coffee-colored powder or granules.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Allergic bronchopulmonary aspergillosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.A. Greenberger" 1 => "R.K. Bush" 2 => "J.G. Demain" 3 => "A. Luong" 4 => "R.G. Slavin" 5 => "A.P. Knutsen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Allergy Clin Immunol Pract" "fecha" => "2014" "volumen" => "2" "paginaInicial" => "703" "paginaFinal" => "708" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spanish guidelines on the evaluation and diagnosis of bronchiectasis in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.Á. Martínez-García" 1 => "L. Máiz" 2 => "C. Olveira" 3 => "R.M. Girón" 4 => "D. de la Rosa" 5 => "M. Blanco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2018" "volumen" => "54" "paginaInicial" => "79" "paginaFinal" => "87" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005400000012/v1_201812020625/S1579212918303355/v1_201812020625/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005400000012/v1_201812020625/S1579212918303355/v1_201812020625/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918303355?idApp=UINPBA00003Z" ]
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