Invasive Pulmonary Aspergillosis Complicating Influenza A Pneumonia in a Previously Healthy Patient

Lewis, Michael I.; Kallenbach, J; Ruff, Paul; Zaltzman, M; Abramowitz, Jack; S, Zwi

doi:10.1378/chest.87.5.691

Cited by 46 publications

(32 citation statements)

References 12 publications

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“…He did have a cold 2 days prior to his very fi rst hospital visit, which is interesting because invasive pulmonary aspergillosis has recently been associated with a few cases of infl uenza virus infection. [17][18][19] Regrettably, an infl uenza antibody titer was not obtained in the present patient. If such an association does exist, the question arise as to why aspergillosis cases are so rare, given the number of infl uenza infections every year.…”

Section: Discussioncontrasting

confidence: 62%

Rapidly progressive invasive pulmonary aspergillosis in a diabetic man

Komase

Kunishima

Yamaguchi

et al. 2007

Journal of Infection and Chemotherapy

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Section: Discussioncontrasting

confidence: 62%

Rapidly progressive invasive pulmonary aspergillosis in a diabetic man

Komase

Kunishima

Yamaguchi

et al. 2007

Journal of Infection and Chemotherapy

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“…Viral infections per se are immunosuppressive and may cause lymphopenia, even in persons with normal immune function. 11 Marrow suppression and neutropenia may result from both the CMV infection and from treatment of CMV with ganciclovir. CMV infection also predisposes patients to GVHD, which, in turn, may favour bacterial infection.…”

Section: Discussionmentioning

confidence: 99%

Gram-negative bacteraemia (GNB) after 428 unrelated donor bone marrow transplants (UD-BMT): risk factors, prophylaxis, therapy and outcome

Mitchell

Derrington

Turner

et al. 2003

Bone Marrow Transplant

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Summary:Gram-negative infection is an important cause of morbidity and mortality after unrelated donor-bone marrow transplantation (UD-BMT). We performed a retrospective case-control study to examine the risk factors, prophylaxis, therapy and outcome of Gram-negative bacteraemia (GNB) in 428 patients undergoing UD-BMT. The incidence of GNB was 3.6% in children and 19% in adults. Of the adults, 11% developed GNB 460 days post UD-BMT. Predisposing risk factors for GNB included 'high-risk' disease status, chronic graft-versushost disease and use of systemic steroids. Fever, a raised C-reactive protein (CRP) and hypotension were common findings at presentation. Patients were routinely given prophylactic ciprofloxacin: resistance to this antibiotic was seen in 33% of isolates. We identified an age-matched control group undergoing UD-BMT over the same time period as the study group. Gram-positive bacteraemia was significantly more common in cases than controls. Mortality from GNB was 17% in children and 24% in adults. We conclude that GNB is a common complication of UD-BMT with a high associated mortality. Patients should be educated further to present rapidly with symptoms suggestive of infection.

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“…The first was treated with low doses of corticosteroids for 5 months because of sarcoidosis and the second had dilated cardiomyopathy, mild renal insufficiency and diabetes mellitus. In the literature there are also case reports on this invasive fungal disease in patients with minimal or mild immunosuppression and even in apparently immunocompetent hosts [6, 7, 8, 9]. Acute aspergillus pneumonia is rarely cited in patients with underlying lung disease who are consequently treated with corticosteroids [5].…”

Section: Discussionmentioning

confidence: 99%

Invasive Pulmonary Aspergillosis

Kristan

Kern²,

Mušič³

2002

Respiration

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Background: Invasive pulmonary aspergillosis usually occurs in immunocompromised patients. Mild abnormality of host defence is usually present in the chronic necrotising form of the disease. Acute aspergillus pneumonia usually affects patients who are seriously immunocompromised. Objectives: The purpose of the study was to highlight the possibility of occurrence of invasive pulmonary aspergillosis also in patients with mild abnormality of host defence. Methods: In a retrospective study 6 patients were analysed. The inclusion criterion was evidence of Aspergillus sp. invasion in lung tissue. Lung tissue was obtained by biopsy or post mortem examination. Results: There were 4 patients with acute aspergillus pneumonia. Two of them were severely immunocompromised – one with dermatomyositis, who was treated with high doses of corticosteroids and methotrexate, and the other with undiscovered miliary tuberculosis, who was treated for myelodysplastic syndrome instead with low doses of corticosteroids. The other 2 had mild immunosuppression: one was suffering from sarcoidosis and was treated with low doses of corticosteroids, the other had dilated cardiomyopathy, renal insufficiency and diabetes mellitus. The two patients with chronic necrotising pulmonary aspergillosis had mild abnormality of host defence: one had reactivation of tuberculosis and diabetes mellitus, the other had inactive tuberculosis and aspergilloma. Conclusions: Invasive pulmonary aspergillosis must be considered also in patients with mild immunosuppression and pulmonary infiltrates which do not respond to conventional treatment with antibiotic chemotherapy. The key to the diagnosis of invasive pulmonary aspergillosis is the histopathological demonstration of fungal invasion in lung tissue.

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Invasive Pulmonary Aspergillosis Complicating Influenza A Pneumonia in a Previously Healthy Patient

Cited by 46 publications

References 12 publications

Rapidly progressive invasive pulmonary aspergillosis in a diabetic man

Rapidly progressive invasive pulmonary aspergillosis in a diabetic man

Gram-negative bacteraemia (GNB) after 428 unrelated donor bone marrow transplants (UD-BMT): risk factors, prophylaxis, therapy and outcome

Invasive Pulmonary Aspergillosis

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