The impact of culture isolation of Aspergillus species: a hospital-based survey of aspergillosis.

Published

Journal Article

The term "aspergillosis" comprises several categories of infection: invasive aspergillosis; chronic necrotizing aspergillosis; aspergilloma, or fungus ball; and allergic bronchopulmonary aspergillosis. In 24 medical centers, we examined the impact of a culture positive for Aspergillus species on the diagnosis, risk factors, management, and outcome associated with these diseases. Most Aspergillus culture isolates from nonsterile body sites do not represent disease. However, for high-risk patients, such as allogeneic bone marrow transplant recipients (60%), persons with hematologic cancer (50%), and those with signs of neutropenia (60%) or malnutrition (30%), a positive culture result is associated with invasive disease. When such risk factors as human immunodeficiency virus infection (20%), solid-organ transplantation (20%), corticosteroid use (20%), or an underlying pulmonary disease (10%) are associated with a positive culture result, clinical judgment and better diagnostic tests are necessary. The management of invasive aspergillosis remains suboptimal: only 38% of patients are alive 3 months after diagnosis. Chronic necrotizing aspergillosis, aspergilloma, and allergic bronchopulmonary aspergillosis have variable management strategies and better short-term outcomes.

Full Text

Duke Authors

Cited Authors

  • Perfect, JR; Cox, GM; Lee, JY; Kauffman, CA; de Repentigny, L; Chapman, SW; Morrison, VA; Pappas, P; Hiemenz, JW; Stevens, DA; Mycoses Study Group,

Published Date

  • December 1, 2001

Published In

Volume / Issue

  • 33 / 11

Start / End Page

  • 1824 - 1833

PubMed ID

  • 11692293

Pubmed Central ID

  • 11692293

Electronic International Standard Serial Number (EISSN)

  • 1537-6591

Digital Object Identifier (DOI)

  • 10.1086/323900

Language

  • eng

Conference Location

  • United States