COMBINATION OF INVASIVE ASPERGILLOSIS AND PNEUMOCYSTIS JIROVECII PNEUMONIA IN HEMATOLOGICAL PATIENTS

Ref ID: 19505

Author:

NN Klimko1*, EA Desyatik1, OV Shadrivova1, SN Khostelidi1, YV Borzova1, RM Chernopyatova1,
SM Ignatyeva1, TS Bogomolova1, MO Popova2, LS Zubarovskaya2, AG Volkova2, BV Afanasev2,
NV Vasileva1

Author address:

1Kashkin Research Institute of Medical Mycology, I.I. Metchnikov North-Western State Medical University,
St. Petersburg, Russian Federation
2I.P. Pavlovo St. Peterburg State Medical University, St. Petersburg, Russian Federation

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Objectives:
To analyze demographic parameters, underlying diseases, etiology, treatment and survival rate of
hematological patients with combination of invasive aspergillosis (IA) and P. jirovecii pneumonia
in St. Petersburg, Russia.
Methods:
The prospective study was conducted for 5 years (2008-2013 y.y.) Diagnosis of IA and P. jirovecii
pneumonia was made according to EORTC/MSG criteria (2008).
Results:
4 hematological patients had been observed with IA and P. jirovecii pneumonia from 2008 up to
2013. The mean age was 25 years (range 18-34), males – 100%, adults – 75%. Main underlying
conditions were: acute myeloid leukemia – 50%, acute lymphoblastic leukemia – 25% and Hodgkin’s
lymphoma – 25%.
The diagnosis of IA was confirmed by mycological investigation. At direct microscopy of
bronchoalveolar lavage (BAL) septate hyphae branching at acute angle were found in one patient
(25%). Aspergillus fumigatus was isolated from BAL of one patient (25%). Galactomannan test in
BAL (“œPlatelia Aspergillus”, BioRad) was positive in 100% of patients.
The diagnosis of P. jirovecii pneumonia was confirmed by «Monofluo» (Bio-Rad) test (75%) and
cytology in BAL (25%).
Antifungal therapy of was performed for all patients: voriconazole (100%), caspofungin (50%),
amphotericin B deoxycholate (25%). Therapy of P. jirovecii pneumonia by cotrimaksozole was
performed for all patients. Duration of antifungal therapy was 30 – 157 days. Overall survival at 12
weeks was 75%.
Conclusions:
This study confirms possibility of combination of invasive pulmonary aspergillosis and P. jirovecii
pneumonia in patients with the oncohematological pathology. The early diagnosis and appropriate
treatment are required.

Abstract Number: 33

Conference Year: 2014

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

New link: NULL

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