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Invasive aspergillosis treated with adjunctive hyperbaric oxygenation: a retrospective clinical series at a single
Lisardo García-Covarrubias1, Diana M Barratt, Robert Bartlett
1Department of Hyperbaric Medicine, University of South Carolina School of Medicine-Palmetto Richland Memorial Hospital, Columbia, USA.
Background:
Invasive aspergillosis is the leading cause of early death in many transplant centers and has a major impact on the management of hematologic malignancies. The mortality rate with current therapy (amphotericin B and surgery) has remained unacceptably high. In vitro data along with a few case reports have suggested a potential benefit of hyperbaric oxygen (HBO).
Methods:
We retrospectively studied all patients referred to our service when histologic specimens suggested invasive aspergillosis. Our main assessment of outcome was survival 3 months after initiation of HBO.
Results:
Ten patients were included. All received adjunctive HBO along with the standard of care. Rhinosinusinal infection was the primary presentation. The most common underlying conditions were hematologic malignancies. Six patients were free of signs of infection 3 months after the first HBO treatment.
Conclusions:
Adjunctive HBO appears to be a valuable tool in this devastating condition. Further studies are warranted to clarify its role.
Insights
Hyperbaric oxygen (HBO) therapy shows promise in treating invasive aspergillosis, a serious fungal infection. This adjunctive treatment improved survival rates in patients with hematologic malignancies.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hyperbaric Medicine
Background:
- Invasive aspergillosis is a primary cause of mortality in transplant recipients and significantly impacts hematologic malignancy management.
- Current treatments like amphotericin B and surgery have high mortality rates.
- Preliminary data suggest hyperbaric oxygen (HBO) may offer therapeutic benefits.
Purpose of the Study:
- To evaluate the efficacy of adjunctive hyperbaric oxygen (HBO) therapy in patients with invasive aspergillosis.
Main Methods:
- Retrospective study of patients with histologic evidence of invasive aspergillosis.
- All patients received standard care plus adjunctive HBO therapy.
- Outcome assessed by survival at 3 months post-HBO initiation.
Main Results:
- Ten patients with invasive aspergillosis were included.
- Rhinosinusinal infection was the most common presentation, often in patients with hematologic malignancies.
- Six out of ten patients survived 3 months post-HBO treatment, showing no signs of infection.
Conclusions:
- Adjunctive HBO therapy appears to be a beneficial treatment for invasive aspergillosis.
- Further research is needed to fully establish the role of HBO in managing this severe condition.