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Aspergillosis.

G P Bodey¹, S Vartivarian

¹Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston 77030.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology

|May 1, 1989

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Aspergillus spores can cause allergic diseases in healthy individuals and invasive infections in immunocompromised patients. Invasive aspergillosis, often caused by Aspergillus fumigatus, presents diagnostic and therapeutic challenges.

Area of Science:

Mycology
Infectious Diseases
Clinical Medicine

Background:

Aspergillus spores are widespread environmental contaminants, frequently found in hospital air systems.
While normal hosts may develop allergic conditions like asthma, invasive aspergillosis predominantly affects severely immunocompromised individuals.

Purpose of the Study:

To review the clinical significance of Aspergillus species, focusing on predisposing factors, common infections, and therapeutic strategies.
To highlight the diagnostic difficulties and treatment limitations for invasive aspergillosis.

Main Methods:

Literature review of Aspergillus infections.
Analysis of predisposing factors and clinical manifestations.
Evaluation of diagnostic methods and therapeutic outcomes.

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Main Results:

Aspergillus colonization can lead to allergic diseases in normal hosts.
Invasive disease is linked to neutropenia, corticosteroid use, prosthetic devices, and tissue trauma.
Pulmonary and sinus infections are common, with Aspergillus fumigatus being the primary pathogen.
The organism invades tissues, including blood vessels, causing thrombosis and infarction.
Diagnosis is challenging due to low sputum culture yield.
Therapy for invasive aspergillosis is often unsatisfactory, with amphotericin B being a key agent.

Conclusions:

Aspergillus poses a significant threat, particularly to immunocompromised patients.
Effective diagnosis and treatment of invasive aspergillosis remain critical challenges in clinical practice.
Combination therapy with amphotericin B and 5-fluorocytosine may offer potential benefits.