Invasive aspergillosis (IA) is an infection of severely immunocompromised that has a high mortality rate, especially if not quickly diagnosed, and diagnosis tends to be very difficult in this group of patients. Most infections are caused by Aspergillus fumigatus but there are some important exceptions and understanding those exceptions better is the key to improving mortality.
- 80% had undergone either a haematopoietic or solid organ transplant and importantly 92% of cases were not neutropenic when IA was diagnosed whereas IA caused by A. fumigatus seems far more dependant on neutropenia (Muhlemann 2005).
- The cases seemed to involve more sites of infection compared with A. fumigatus with 46% affecting sites such as skin, brain
- Mortality is high and the authors comment that this may be due to the lack of optimisation of antifungal therapy for infections caused by this species of Aspergillus.
Recognising the rare infections caused by this species rather than A fumigatus is clearly important to optimise survival rates and that isn't going to be easy in the limited time available to treat IA. We urgently need to optimise therapy tailored to this species of the pathogen.