Invasive aspergillosis in patients with acquired immunodeficiency syndrome: Report of 33 cases

Lortholary, Olivier; Meyohas, Marie-Caroline; Dupont, B.; Cadranel, Jacques; Salmon‐Céron, Dominique; Peyramond, D.; Simonin, Daniel

doi:10.1016/0002-9343(93)90258-q

Cited by 181 publications

(100 citation statements)

References 38 publications

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“…A low CD4 count (,100 cells?mm -3 ) is present in almost all cases of AIDS-associated aspergillosis, and half of HIVinfected patients with IPA have coexistent neutropenia or are on corticosteroid therapy. The rest of the cases appear to have no particular risk factors other than advanced AIDS [19][20][21]. There is increased incidence of tracheobronchial involvement in these patients in addition to the usual clinical picture of IPA [21,31].…”

Section: Risk Factorsmentioning

confidence: 95%

Pulmonary aspergillosis: a clinical review

Kousha¹,

Tadi²,

Soubani³

2011

Eur Respir Rev

599

596

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Aspergillus is a mould which may lead to a variety of infectious, allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients and those with chronic obstructive pulmonary disease appear to be at an increased risk. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic necrotising aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Aspergilloma is usually found in patients with previously formed cavities in the lung, whereas allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. Current approaches for the diagnosis and management of these syndromes are discussed.

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Section: Risk Factorsmentioning

confidence: 95%

Pulmonary aspergillosis: a clinical review

Kousha¹,

Tadi²,

Soubani³

2011

Eur Respir Rev

599

596

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“…Although the conventional form of amphotericin B remains the drug of choice for the treatment of life-threatening fungal infections, its clinical efficacy is suboptimal in the immunocompromised host (10). In several studies (5,17,20,26), death was attributed to disseminated aspergillosis in 27 of 62 patients, despite adequate treatment with amphotericin B (10).…”

Section: Vol 39 2001 Comparison Of E-test and Nccls M38-p For Mold mentioning

confidence: 99%

“…2) for 4 of the 16 isolates of A. flavus tested and MICs were 2 to Ͼ8 g/ml for the other isolates tested. Clinical resistance of this species to amphotericin B has been reported; unfortunately, the MICs for the infecting isolates were not reported (5,17,20,26). It is noteworthy that the E-test appeared to be superior to the NCCLS method for yeasts (23) in its ability to detect amphotericin B-resistant Candida spp.…”

Section: Vol 39 2001 Comparison Of E-test and Nccls M38-p For Mold mentioning

confidence: 99%

Comparison of the E-test with the NCCLS M38-P Method for Antifungal Susceptibility Testing of Common and Emerging Pathogenic Filamentous Fungi

2001

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The National Committee for Clinical Laboratory Standards (NCCLS) M38-P method describes standard parameters for testing the fungistatic antifungal activities (MICs) of established agents against filamentous fungi (molds). The present study evaluated the in vitro fungistatic activities of itraconazole and amphotericin B by the E-test and the NCCLS M38-P microdilution method against 186 common and emerging pathogenic molds (123 isolates of Aspergillus spp. [five species], 16 isolates of Fusarium spp. [two species], 4 Paecilomyces lilacinus isolates, 5 Rhizopus arrhizus isolates, 15 Scedosporium spp., 18 dematiaceous fungi, and 5 Trichoderma longibrachiatum isolates). The agreement between the methods for amphotericin B MICs ranged from 70% for Fusarium solani to >90% for most of the other species after the first reading; agreement was dependent on both the incubation time and the species being evaluated. Major discrepancies between the amphotericin B MICs determined by the E-test and the NCCLS M38-P method were demonstrated for three of the five species of Aspergillus tested and the two species of Fusarium tested. This discrepancy was more marked after 48 h of incubation; the geometric mean MICs determined by the E-test increased between 24 and 48 h from between 1.39 and 3.3 g/ml to between 5.2 and >8 g/ml for Aspergillus flavus, Aspergillus fumigatus, and Aspergillus nidulans. The agreement between the itraconazole MICs determined by the E-test and the NCCLS M38-P method ranged from 83.3% for A. nidulans to >90% for all the other species tested; the overall agreement was higher (92.7%) than that for amphotericin B (87.9%). The agreement was less dependent on the incubation time. Clinical trials need to be conducted to establish the role of the results of either the E-test or the NCCLS M38-P method in vitro for molds with the two agents as predictors of clinical outcome.

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“…El contexto en el que ocurre es el de recuento de linfocitos T-CD4 < 100 céls/mL, con otras IO y sin TARV. La localización más habitual es pulmonar y se presenta clínicamente como una neumonía necrosante o una traqueo-bronquitis 24 . Hay fi ebre, disnea, dolor torácico, tos, hemoptisis e hipoxemia.…”

Section: Diagnósticounclassified

Diagnóstico y tratamiento de infecciones oportunistas en el paciente adulto con infección por VIH/SIDA

2011

Rev. chil. infectol.

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Invasive aspergillosis in patients with acquired immunodeficiency syndrome: Report of 33 cases

Cited by 181 publications

References 38 publications

Pulmonary aspergillosis: a clinical review

Pulmonary aspergillosis: a clinical review

Comparison of the E-test with the NCCLS M38-P Method for Antifungal Susceptibility Testing of Common and Emerging Pathogenic Filamentous Fungi

Diagnóstico y tratamiento de infecciones oportunistas en el paciente adulto con infección por VIH/SIDA

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