Journal Article

Comparison of Epidemiological, Clinical, and Biological Features of Invasive Aspergillosis in Neutropenic and Nonneutropenic Patients: A 6-Year Survey

A. Cornillet, C. Camus, S. Nimubona, V. Gandemer, P. Tattevin, C. Belleguic, S. Chevrier, C. Meunier, C. Lebert, M. Aupée, S. Caulet-Maugendre, M. Faucheux, B. Lelong, E. Leray, C. Guiguen and J.-P. Gangneux

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 5, pages 577-584
Published in print September 2006 | ISSN: 1058-4838
Published online September 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/505870
Comparison of Epidemiological, Clinical, and Biological Features of Invasive Aspergillosis in Neutropenic and Nonneutropenic Patients: A 6-Year Survey

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Background. Invasive aspergillosis is an opportunistic infection that occurs mainly among patients with prolonged neutropenia. Few data are available on invasive aspergillosis in nonneutropenic patients.

Methods. The aim of this survey was to compare neutropenic and nonneutropenic patients who had received a diagnosis of invasive aspergillosis at our institution during a 6-year period.

Results. Among the 88 cases of invasive aspergillosis analyzed here, 12 were histologically proven, 52 were probable, and 24 were possible. Forty-seven percent of cases were diagnosed in the intensive care unit, and 40% were diagnosed in hematology units. Neutropenia was a risk factor for 52 patients (59%), most of whom had hematological or solid malignancies. Among the 36 nonneutropenic patients (41%), the main underlying conditions were steroid-treated chronic obstructive pulmonary disease, asthma, rheumatoid arthritis, giant-cell arteritis, and microvascular disorders; 10 patients were recipients of solid-organ transplants, and 1 patient was seropositive for human immunodeficiency virus. The distribution of proven and probable invasive aspergillosis was similar for neutropenic and nonneutropenic patients. The mortality rate was 71.5% overall and was significantly higher among nonneutropenic patients than among neutropenic patients (89% vs. 60%; P < .05). Compared with neutropenic patients, nonneutropenic patients were significantly less likely to have symptoms of invasive aspergillosis and more likely to have frequent intercurrent pneumonia due to another microorganism. The sensitivity of mycological examination of bronchoalveolar lavage fluid specimens was higher for nonneutropenic patients than for neutropenic patients (85% vs. 58%; P < .05), whereas the sensitivity of antigenemia was the same for the 2 populations (65% vs. 64%). Findings on thoracic computed tomographs were similar, except that segmental areas of consolidation occurred more frequently among neutropenic patients.

Conclusion. This survey at a whole institution underlines the high number of cases of invasive aspergillosis among nonneutropenic patients, with an overall mortality rate that was significantly higher than that for neutropenic patients.

Journal Article.  4314 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.