Pulmonary aspergillosis in acquired immune deficiency syndrome: Autopsy study of an emerging pulmonary complication of human immunodeficiency virus infection

Nash, Gerald D.; Irvine, Rebecca A.; Kerschmann, Russell; Herndier, Brian

doi:10.1016/s0046-8177(97)90200-8

Cited by 20 publications

(10 citation statements)

References 21 publications

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“…In some AIDS patients aspergillosis may have a subacute or chronic course 18 , as observed in the cases reported here. It is possible that absolute neutrophil counts greater than 500 cells/µL and preserved capacity of recuperation of the bone marrow protect patients from an acute development of aspergillosis.…”

Section: Discussionsupporting

confidence: 69%

“…The presence of cytomegalovirus, incidentally found in the lung of the first patient, has also been implicated in the development of pulmonary aspergillosis 18,26 .…”

Section: Discussionmentioning

confidence: 99%

“…Although infrequent in HIV-infected patients (0 to 12% prevalence at autopsy), the disease is highly lethal in advanced AIDS 3,5 . In HIVinfected patients, Aspergillus pulmonary lesions are characterized by interstitial or alveolar infiltrates, nodules, cavities, abscesses, hemorrhagic infarction, or pleural discharge 6,18 . The central nervous system may also be secondarily involved in AIDS patients 7,16,24 .…”

Section: Introductionmentioning

confidence: 99%

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Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients

Martínez

Castro

Machado

et al. 2009

Rev. Inst. Med. trop. S. Paulo

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SUMMARYAlthough uncommon, invasive aspergillosis in the setting of AIDS is important because of its peculiar clinical presentation and high lethality. This report examines two AIDS patients with a history of severe cellular immunosuppression and previous neutropenia, who developed subacute invasive aspergillosis. One female patient developed primary lung aspergilloma, with dissemination to the mediastinum, vertebrae, and spine, which was fatal despite antifungal treatment. The second patient, who had multiple cavitary brain lesions, and eye and lung involvement, recovered following voriconazole and itraconazole, and drugs for increasing neutrophil and CD4+ lymphocyte levels. These cases demonstrate the importance of Aspergillus infections following neutropenia in AIDS patients, and emphasize the need for early and effective antifungal therapy.

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Section: Discussionsupporting

confidence: 69%

“…The presence of cytomegalovirus, incidentally found in the lung of the first patient, has also been implicated in the development of pulmonary aspergillosis 18,26 .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients

Martínez

Castro

Machado

et al. 2009

Rev. Inst. Med. trop. S. Paulo

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“…munocompromised due to HIV infection, neoplasms, chemotherapy, transplantation, steroid therapy, and underlying lung disease (Nash et al, 1997;Teh et al, 1995). Children with neutropenia or prolonged antibiotic therapy are especially susceptible to infection (Shenep & Flynn, 1997).…”

mentioning

confidence: 99%

“…Children with neutropenia or prolonged antibiotic therapy are especially susceptible to infection (Shenep & Flynn, 1997). Species of Aspergillus, in particular, are recognized as significant emerging pathogens in persons with HIV/AIDS, causing invasive sinusitis and invasive pulmonary disease (Mylonakis et al, 1997;Nash et al, 1997). Many others are at risk for allergic hypersensitivity to inhaled microbes and animal proteins.…”

mentioning

confidence: 99%

Professional Specialty Cleaning: A Critical Element of Fungal Reservoir Control in Homes of the Immunocompromised and Hypersensitive

Cole

2001

Appl Biosaf.

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Percutaneous treatment with amphotericin B of mycotic lung lesions from invasive aspergillosis: results in 10 immunocompromised patients

Veltri

Anselmetti

et al. 2000

European Radiology

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The aim of this study was to evaluate the efficacy of percutaneous treatment of pulmonary lesions from invasive aspergillosis in immunocompromised patients. From 1992 to 1998, ten patients (seven men and three women; mean age 56 years) affected by hematological neoplasms (8 acute myeloid leukemias, 2 non-Hodgkin's lymphomas) and post-chemotherapy prolonged neutropenia developed pulmonary lesions from invasive aspergillosis. A total of 13 lesions (diameter 2-7 cm, median 5 cm) were treated percutaneously due to insufficiency of the high-dose i.v. therapy; under CT guidance, a median of 10 cm3 per session of a 1 mg/cm3 diluted solution of amphotericin B was injected through a fine needle (21-22 G); 45 sessions overall were performed (one to five per lesion, median four), according to the volume of the nodules, tolerance, and complications. The results were retrospectively evaluated either radiologically or clinically. Complications were cough, mild hemoptysis, and small pneumothorax and/or pleural effusion. No major complications occurred. One month after the beginning of treatment, 8 lesions completely resolved, 4 greatly improved, and 1 was not significantly reduced. In all ten patients symptoms improved (eight of ten could restart chemotherapy as scheduled). After antiblastic retreatment, 1 patient had mycotic recurrence. In our experience transthoracic topical treatment with amphotericin B of single or few lung lesions from invasive aspergillosis was effective, affording a rapid improvement of the lesions and symptoms, and allowing continuation of chemotherapy as scheduled, thereby reducing the risk of recurrences.

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Pulmonary aspergillosis in acquired immune deficiency syndrome: Autopsy study of an emerging pulmonary complication of human immunodeficiency virus infection

Cited by 20 publications

References 21 publications

Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients

Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients

Professional Specialty Cleaning: A Critical Element of Fungal Reservoir Control in Homes of the Immunocompromised and Hypersensitive

Percutaneous treatment with amphotericin B of mycotic lung lesions from invasive aspergillosis: results in 10 immunocompromised patients

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