Rôle des champignons dans la pathologie respiratoire au cours de la mucoviscidose

Contribution of fungi to respiratory infections diseases in cystic fibrosis Different fungal species can colonize the respira- tory tract of patients with cystic fibrosis and lead to infectious and/or allergic diseases that contribute to a decrease in their respiratory function. Asper- gillus fumigatus, Scedosporium apiospermum, Exophiala dermatitidis or Aspergillus terreus are the most important fungi in this context. In non transplant patients, the main fungal disease is allergic bronchopulmonary aspergillosis. It is usually caused by A. fumigatus and there is now a consensus about its diagnosis that requires the association of clinical, radiological and bio- logical criteria. Other Aspergillus diseases such as asthma, fungus ball or bronchitis can occur in cystic fibrosis, but they remain very rare. Scedos- porium apiospermum, the second most frequent filamentous fungus, is able to colonize chronically the airways and it has been previously involved in few cases of allergic bronchopulmonary mycosis. Exophiala dermatitidis is essentially an agent of bronchial colonization, but it may be responsible for pneumonia. In the immunosuppression episode that succeeds transplantation, fungi can induce invasive pulmo- nary mycoses and disseminated infections with a very severe prognosis. The abovementionned fungal species can be the causal agents of these systemic mycoses as well as yeasts of the genus Candida that play a pathogenic role in cystic fibrosis exclusively in this post-transplantation phase.