Aspergillus as a Cause of Fungal Empyema Thoracis : Experience of a Cancer Center

Ref ID: 19572

Author:

JM Munita1,3*, MR Vial2,3, J Tarrand2, C Jimenez2, DP Kontoyiannis2

Author address:

1Infectious Diseases, University of Texas Medical School, Houston, TX, USA
2Infectious Diseases, MD Anderson Cancer Center, Houston, TX, USA
3Infectious Diseases, Clinica Alemana and Universidad del Desarrollo School of Medicine, Santiago, Chile

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Purpose:
Empyema thoracis due to Aspergillus is rare and information about this condition is scarce.
Moreover, the interpretation of a positive pleural fluid for this mold is challenging. To that end, we
retrospectively evaluated patients with a pleural culture for Aspergillus spp. in order to describe the
experience of a cancer center.
Methods:
We reviewed the records of all patients with at least one pleural fluid culture growing Aspergillus spp
(01/2005 – 03/2013) at MD Anderson Cancer Center, Houston, TX. All clinical and demographical
information was obtained in order to characterize patients with empyema thoracis due to Aspergillus.
Subjects who did not receive antifungal therapy or were subsequently found to have a negative
pleural culture within 7 days were considered contamination.
Results:
We identified 8 such patients; median age was 55 yrs. (19 – 74 yrs.) and 4 of them were female.
Among them, 6/8 patients were considered to have a true empyema and received systemic antifungal
therapy accordingly. All but one of these patients had a hematological neoplasia. On the contrary, the
2 patients in whom the culture was considered a contaminant had an underlying solid organ tumor.
Pleural fluid characteristics did not vary between patients with true infection and contamination.
Four out of 6 patients with true infection had concomitant involvement of other sites (3 cases
of pneumonia and 1 sinusitis). With regard to the species, A. fumigatus was the most frequently
recovered (4 occasions), followed by 1 A. terreus, 1 A. niger and 2 Aspergillus sp. Only 2 patients
with true Aspergillus empyema survived, both of them had no evidence of invasive disease in other
sites.
Conclusion:
Empyema due to Aspergillus is rare and is typically seen in highly immunosuppressed patients with
hematologic cancer. This condition carries a high mortality and it is usually seen in the setting of
concomitant invasive fungal infection.

Abstract Number: 98

Conference Year: 2014

Link to conference website: http://www.AAA2014.org

New link: NULL

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