Invasive aspergillosis in neutropenic patients with hematological disorders

Ofer Shpilberg, Dan Douer, Anna Goldschmied-reouven, Colin Block, Isaac Ben-bassat, Bracha Ramot

Research output: Contribution to journalArticlepeer-review

Abstract

Between 1983-1988, 72 patients with acute leukemia and 4 with aplastic anemia were treated in the Hematology Unit of The Chaim Sheba Medical Center. Ten patients with acute leukemia developed invasive pulmonary aspergillosis and 2 with aplastic anemia developed invasive aspergillosis of the nose and paranasal sinuses. These infections were diagnosed during a period of profound neutropenia while these patients were receiving broad spectrum antibiotics. The diagnosis of pulmonary aspergillosis was based on positive sputum cultures in 4 cases and on the appearance of typical clinical and radiologic features in six. In 2 culture-positive and in one culture-negative patient, the diagnosis was confirmed at autopsy. Thus, the diagnosis was definitive in 5 patients and probable in the remaining five patients. The 5 patients who achieved remission responded to antifungal treatment and recovered, while of the 5 who eventually died from the fungal infection, 4 did not achieve remission, and one died while in complete remission. In the 2 patients with aplastic anemia, aspergillosis was detected in cultures from necrotic nasal tissue. Both patients remained neutropenic, failed to respond to antifungal treatment and died within a short time after diagnosis. From this experience it appears that invasive aspergillosis in neutropenic patients is potentially curable if treated early by amphotericin B, provided that the neutrophil count recovers.

Original languageEnglish
Pages (from-to)257-262
Number of pages6
JournalLeukemia and Lymphoma
Volume4
Issue number4
DOIs
StatePublished - 1991
Externally publishedYes

Keywords

  • Acute leukemia
  • Aplastic anemia
  • Invasive aspergillosis
  • Neutropenia

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