Abstract
Aspergillosis is an infrequent but commonly fatal infection among HIV-infected individuals. We review 342 cases of pulmonary Aspergillus infection that have been reported among HIV-infected patients, with a focus on invasive disease. Invasive pulmonary aspergillosis usually occurs among patients with <50 CD4 cells/mm3. Major predisposing conditions include neutropenia and steroid treatment. Fever, cough, and dyspnea are each present in >60% of the cases. BAL is often suggestive, but biopsy specimens are necessary for definite diagnosis. Amphotericin B is the mainstay of treatment and mortality is > 80%. Avoiding neutropenia and judicious use of steroids may be helpful in prevention. Aggressive diagnostic approach, early initiation of treatment, adequate dosing of antifungals, and close follow-up may improve the currently dismal prognosis.
Publication types
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Meta-Analysis
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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AIDS-Related Opportunistic Infections / drug therapy
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AIDS-Related Opportunistic Infections / immunology
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AIDS-Related Opportunistic Infections / pathology
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AIDS-Related Opportunistic Infections / physiopathology*
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AIDS-Related Opportunistic Infections / prevention & control
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Adrenal Cortex Hormones / therapeutic use
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Amphotericin B / administration & dosage
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Amphotericin B / therapeutic use
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Antifungal Agents / administration & dosage
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Antifungal Agents / therapeutic use
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Aspergillosis / drug therapy
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Aspergillosis / immunology
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Aspergillosis / pathology
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Aspergillosis / physiopathology*
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Aspergillosis / prevention & control
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Biopsy
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Bronchoalveolar Lavage Fluid / microbiology
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CD4 Lymphocyte Count
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Cough / physiopathology
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Dyspnea / physiopathology
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Female
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Fever / physiopathology
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Follow-Up Studies
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Humans
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Lung Diseases, Fungal / drug therapy
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Lung Diseases, Fungal / immunology
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Lung Diseases, Fungal / pathology
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Lung Diseases, Fungal / physiopathology*
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Lung Diseases, Fungal / prevention & control
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Male
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Neutropenia / complications
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Neutropenia / prevention & control
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Prognosis
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Risk Factors
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Survival Rate
Substances
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Adrenal Cortex Hormones
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Antifungal Agents
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Amphotericin B