Aspergillosis in a cancer hospital

Hutter, R. V. P.; Lieberman, Philip; Collins, Harvey S.

doi:10.1002/1097-0142(196406)17:6<747::aid-cncr2820170610>3.0.co;2-d

Cited by 54 publications

(13 citation statements)

References 25 publications

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“…Until recently, aspergillosis was a rare infection, even among immunocompromised patients. Only 30 cases of aspergillosis were found in all autopsies performed between 1951 and 1963 at Memorial Sloan-Kettering Cancer Center [6]; between 1964 and 1976, 184 cases were detected, mostly among patients with haematological malignancies [7].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary fungal infections in immunocompromised patients: incidence and risk factors

Eiff

Roos

Fegeler

et al. 1994

Mycoses

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Summary In a prospective study, 178 patients with fever > 38.4 °C and newly diagnosed pulmonary infiltrates underwent bronchoscopy with bronchoalveolar lavage (BAL), aspiration of bronchial secretions (BS) and, in 71 cases, protected specimen brushing (PSB). In 42/143 immunocom‐promised patients (haematological malignancies, n= 92; AIDS, n = 22; immunosuppressant therapy, n = 29) and in 4/35 patients with no defined underlying disease fungal pneumonia was present (candidosis, n= 35; aspergillosis, n = 8 mixed fungal infection, n = 3). Candidosis was combined, in 17 cases, with Aspergillus (n=3), bacterial (n= 15) or cytomegalovirus (n=2) infection. Aspergillosis was combined in eight cases with infection with Candida (n = 3), Pneumocystis carinii (n=1) or bacteria (n = 5). The sensitivity of BAL and PSB in Candida pneumonia was 48% and 50%, respectively; specificity was 75% and 74% respectively. Bronchial secretions were more sensitive in detecting Candida pneumonia, but specificity was only 55%. In aspergillosis, the specificity of BAL, BS and PSB in each case was 100%; the sensitivity of BAL, BS and PSB was 38%, 64% and 100%. Twenty‐four fungal infections were fatal. Unfavourable prognostic factors were respiratory failure needing mechanical ventilation, diffuse bilateral pulmonary infiltrates, mixed fungal infections and start of i.v. antifungal treatment > 14 days after fever onset, which were associated with a mortality rate of 74%, 67%, 67% and 63% respectively.

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Section: Introductionmentioning

confidence: 99%

Pulmonary fungal infections in immunocompromised patients: incidence and risk factors

Eiff

Roos

Fegeler

et al. 1994

Mycoses

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“…In early investigations, "primary" invasive aspergillosis was diagnosed in patients without underlying immunosuppression, but the majority of the small numbers of cases reported occurred in patients with leukemia, corticosteroid therapy, and broad spectrum antibiotic therapy (Table 5). We now appreciate that disseminated aspergillosis is an acute or subacute illness which occurs in many patients with granulocytopenia, particularly those receiving corticosteroid therapy, and in those with chronic granulomatous disease (Hutter et al, 1964;Bodey, 1966;Rifkind et al, 1967;Young et al, 1970;Hart et al, 1969;Meyer et al, 1973;Chang et al, 1976;Lazarus and Neu, 1975;. Fungal infections occurred in 20% of one large series, with Aspergillus comprising 78% of these infections .…”

Section: Management Of Invasive Aspergillosismentioning

confidence: 99%

“…As shown in Table 5, Hutter et al (1964) reported a series of 30 cases diagnosed postmortem, by definition a poor outcome. Bodey (1966) reported aspergillosis in 11% of fatalities due to acute leukemia between 1959 and 1964.…”

Section: Management Of Invasive Aspergillosismentioning

confidence: 99%

Aspergillus and Aspergillosis

Bossche¹,

Mackenzie²,

Cauwenbergh³

1988

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“…[13–15] However it presents as invasive and fulminant variant in cancer patients with impaired host defense,[1617] disease and treatment-induced leucopenia, long-term use of antibiotics or corticosteroids. [18] This article is reported because of the rarity of the invasive variant occurring in immunocompetent host.…”

Section: Introductionmentioning

confidence: 99%