Invasive Aspergillosis in A Thai University Hospital

CHITTIMA THIBBADEE, MD, SASISOPIN KIERTIBURANAKUL, MD;

Author address: 

Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand.

Abstract: 

Background: Invasive aspergillosis (IA) is a serious infection in immunocompromised host and is an important cause of death among these patients. Clinical manifestation is various and depends on many factors. We aimed to determine patients’ characteristics, clinical presentations, treatment, and outcomes of adult patients with IA in Ramathibodi Hospital. Metods: We retrospectively reviewed medical and laboratory records of adult patients with IA from Janury 2000 to December 2005. Results: A total of 94 patients were included in the study and mean age was 47.9±19.4 (range, 178722;89) years old. Fifty-four (57.8%) were male. Acute leukemia was the most common underlying condition (29.8%) followed by diabetes millitus and systemic lupus erythematosus. Major predisposing factors were neutropenia (38.9%), chemotherapy (32.6%) and corticosteroid usage (24.5%). These patients were classified as proven IA (n = 35), probable IA (n = 10), and possible IA (n = 49) according to the standard definitions for8722;invasive fungal infection for clinical research. The most common sites of infection were lungs (67%), sinus (17.8%), and eyes (7.4%). Aspergillus fumigatus (57.5%) was the most frequently isolated followed by A. flavus (20%) and A. niger (12.5%). Thirteen patients (14%) had concurrent with other infectious diseases, such as cytomegalovirus or granulomatous diseases. Amphotericin B followed by itraconazole was the mainstay of treatment. Thirty-six patients (38.3%) had complete or partial response to the treatment and 44 patients (46.8%) died due to aspergillosis. Median survival for all causes of death was approximately 30 days. The significant risk factors of death by multivariate analysis were corticosteroid usage (OR 10.65 (1.03110.15); P = 0.047) and pulmonary infections (OR 18.06 (4.288722;76.17); P
2006

abstract No: 

547

Full conference title: 

Infectious Diseases Society of America, 44th Annual Meeting
    • IDSA 44th