Aspergillosis: A Case Series

Ryan M. LLORIN, Jennifer A. CHUA.

Author address: 

St. Luke's Medieal Cente~ Quezon City, Philippines

Abstract: 

Objective: To present a clinical profile of aspergillosis patients encountered in our institution Significance: Aspergillosis has become the most common life threatening invasive mycosis as tile population at risk increases dramatically in tile past decades. Given its wide spectrum of clinical manifestations, a physician should possess a high index of suspicion to recognize this infection. The introduction of newer antifungal agents in re cent years has prompted clinicians to be knowledgeable of its recognition, for early diagnosis portends better outcome. Study Design: Retrospective descriptive study Setting: Tertiary urban mfiversity hospital Population: Hospitalized patients with aspergillosis Methodology: In this retrospective, descriptive study, we reviewed tile charts of patients diagnosed with Aspergillosis who were admitted to the St. Luke's Medical Center from 1998 to 2004. We profiled their clinical characteristics, radiological features, histopathological and culture results, treatment regimens and their outcome. Results: There were 14 cases of Aspergillosis from 1998 to 2004. Tile median age was 54 years. Nine patients (164.3%1) were immunocompromised. The most common immunocompromised states were diabetes mellitus (36%1) and kidney transplantation (121%). Pulmonary aspergillosis was seen in 11 patients while 3 patients had extrapulmonary aspergillosis. In tile pulmonary aspergillosis group, 6 (172%1) had invasive disease. Tile most common manifestations were cough (55%), hemoptysis (155%1) and dyspnea (45%). The most common radiological features were pasenchymal consolidations and infiltrates (64% each) on cheat x-lay and cavitations (180%1) on CT scan. Only one patient was diagnosed by means of both histopathology and culture. Seven patients were diagnosed through culture while three were diagnosed by histopathology. Different antifungal agents were given to patients, with Amphotericin B tile most common treatment regimen and with the most number of adveize reactions. In tile extrapulmonary group, clinical presentation was based on site of involvement. Two were diagnosed through histopathology while one had culture growth. Radiological exams showed tissue masses. Surgical resections were per formed successfully while one underwent oral antifungal therapy. The case fatality rate of pulmonary aspergillosis was 27% wine all survived in tile extrapulmonaxy aspergillosis group. Conclusiml: Aspergillosis has become a foianidable infection in a time of increasing immunosuppression. Early diagnosis is important in achieving favorable results. With newer antifungal agents, prognosis may eventually improve. In the meantime, novel treatment strategies are being explored.
2005

abstract No: 

CR.1

Full conference title: 

International Congress on Chemotherapy, 24th Meeting
    • ICC 24 th