Invasive pulmonary aspergillosis: High incidence of disseminated intravascular coagulation in fatal cases
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
40
Journal Issue
2
Pages
141-147
Date Issued
2007
Author(s)
Abstract
Background and Purpose: Disseminated intravascular coagulation (DIC) is a rarely described finding in invasive pulmonary aspergillosis (IPA) with unclear impact on mortality. Methods: This study included patients with positive cultures of Aspergillus spp. from respiratory specimens, serological evidence of aspergillosis, or lung biopsy findings supporting aspergillosis treated at National Taiwan University Hospital from January 1999 to June 2005. IPA was defined based on the consensus of the European Organization for Research and Treatment of Cancer, and the Mycosis Study Group of the National Institute of Allergy and Infectious Diseases. Univariate logistic regression analysis was used to evaluate the factors associated with mortality. Results: Proven or probable IPA was diagnosed in 26 patients. Hematological malignancy was found in 11 patients (42%) and immunosuppressive agents had been administered to 17 patients (65%). Among 20 culture-proven infections (77%), the most frequently encountered fungi were Aspergillus fumigatus (46%) and Aspergillus flavus (23%). The overall mortality rate was 62%. Univariate and multivariate analyses revealed that DIC was the only factor that was significantly associated with death attributable to IPA (p<0.01). Conclusions: IPA is associated with a high mortality rate, particularly for patients with DIC. ? 2007 Journal of Microbiology, Immunology and Infection.
SDGs
Other Subjects
amphotericin B; antifungal agent; caspofungin; fluconazole; immunosuppressive agent; itraconazole; voriconazole; adult; aged; article; aspergillosis; Aspergillus flavus; Aspergillus fumigatus; disseminated intravascular clotting; female; fungus culture; hematologic malignancy; human; incidence; lung aspergillosis; lung biopsy; major clinical study; male; mortality; multivariate analysis; rare disease; risk factor; serodiagnosis; species invasion; Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Fungal; Aspergillosis; Aspergillus flavus; Aspergillus fumigatus; Biopsy; Disseminated Intravascular Coagulation; Hematologic Neoplasms; Humans; Immunosuppression; Incidence; Logistic Models; Lung; Lung Diseases, Fungal; Male; Middle Aged; Multivariate Analysis
Type
journal article