LIFE THREATENING ASPERGILLUS INFECTIONS FAIRLY COMMON IN NON-IMMUNOCOMPROMISED PATIENTS

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It has long been known than Aspergillus species (especially A. fumigatus, flavus, niger and terreus) can cause life threatening infections in severely immunocompromised patients such as those with HIV/AIDS , leukemia/lymphoma, or on immune suppressing drugs for bone or organ transplants.

Mireya Wessolossky et al. Invasive Aspergillus infections in hospitalized patients with chronic lung disease. Infection and Drug Resistance 2013;6:33-39.

Non immunocompromised patients were long believed not to be at risk for severe Aspergillus infections. However, in recent years it also has becoming apparent that life threatening Aspergillus infections can occur in patients without severe immune system compromise.
A recent seven year survey in a Massachusetts hospital system reported 113 cases of invasive Aspergillus infection of the lung. About half of these cases (56) were immunocompromised, while the other half (57) had chronic lung disease without any signs of obvious immunocompromise. Mortality was high in the chronic lung patients with invasive aspergillosis- with 26 of 57 (45%) dying within one month. These 57 chronic lung disease patients had emphysema, asthma, bronchitis, sarcoidosis or similar diseases. The authors stated that physicians need to be more vigilant for Aspergillus infections in “nontraditional” patients, and that more rapid diagnosis and antifungal treatment can save many lives.

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