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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Invasive mould disease in haematologic patients: comparison between fusariosis and aspergillosis

F Nucci1, S A Nouér2, D Capone3

  • 1Haematology Service, University Hospital, Universidade Federal Fluminense, Niteroi, Brazil.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|May 23, 2018
PubMed
Abstract

Insights

Invasive aspergillosis (IA) and invasive fusariosis (IF) in hematologic patients present differently, with IA affecting airways and IF causing fever and skin lesions. Outcomes were poorer for invasive fusariosis.

Area of Science:

  • Mycology
  • Hematology
  • Infectious Diseases

Background:

  • Invasive aspergillosis (IA) and invasive fusariosis (IF) are serious fungal infections in immunocompromised patients.
  • Distinguishing between IA and IF is crucial for appropriate treatment and improved patient outcomes.

Purpose of the Study:

  • To compare the epidemiology, clinical presentation, diagnosis, treatment, and outcomes of IA and IF in hematologic patients.
  • To identify key differences and similarities in the presentation and management of these two invasive fungal infections.

Main Methods:

  • Retrospective chart review of 62 hematologic patients (36 with IA, 26 with IF) diagnosed between 2006 and 2017.
  • Comparison of baseline characteristics, exposures, clinical manifestations, treatments, and outcomes.

Main Results:

  • IA commonly presented with pneumonia and sinusitis, while IF was associated with fever, skin lesions, and positive blood cultures.
  • The halo sign was more frequent in IA pneumonia. Serum galactomannan was positive in both, but more frequently in IA.
  • 30-day survival was significantly higher for IA (77.7%) compared to IF (46.1%).

Conclusions:

  • IA and IF exhibit distinct clinical features in hematologic patients, with IA primarily affecting the airways and IF presenting with fever, skin lesions, and positive blood cultures.
  • A subset of IF patients can mimic IA, presenting with fever, lung infiltrates, and positive serum galactomannan.
  • These findings highlight the importance of recognizing the varied presentations of IA and IF for timely diagnosis and management.
Keywords:
AspergillosisEpidemiologyFusariosisGalactomannanInvasive fungal disease

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