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Aspergillus species colonization and invasive disease in patients with AIDS

K J Pursell1, E E Telzak, D Armstrong

  • 1Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 1, 1992
PubMed

Insights

Invasive aspergillosis is a rare but serious infection in patients with acquired immunodeficiency syndrome (AIDS). Early diagnosis and consideration of amphotericin B therapy are crucial for affected individuals.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Immunology

Background:

  • Invasive aspergillosis is an uncommon but severe opportunistic infection.
  • Patients with acquired immunodeficiency syndrome (AIDS) are at risk for opportunistic infections.
  • Aspergillus species are common molds found in the environment.

Observation:

  • Over a 10-year period, Aspergillus species were isolated from respiratory sites of 45 out of 972 patients with AIDS.
  • Invasive aspergillosis was confirmed in 4 patients post-mortem and suspected in 1 additional patient.
  • A fifth case was confirmed at autopsy without prior respiratory sample.
  • All patients with invasive aspergillosis had traditional risk factors: neutropenia, hematologic malignancy, and/or corticosteroid use.

Findings:

  • Invasive aspergillosis occurred in 5 patients with AIDS at the institution.
  • Literature review identified an additional 13 cases of invasive aspergillosis in AIDS patients.
  • Traditional risk factors were present in all documented cases.

Implications:

  • Highlights the importance of considering invasive aspergillosis in AIDS patients with respiratory symptoms.
  • Suggests amphotericin B as a potential therapy for neutropenic AIDS patients with pneumonia of uncertain origin and Aspergillus isolation.
  • Emphasizes the need for vigilance and prompt diagnosis in immunocompromised populations.

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