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Diagnosis and treatment of invasive pulmonary aspergillosis in HIV-infected patients

Author
John W Baddley, MD, MSPH
Section Editor
John G Bartlett, MD
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

In the years prior to the introduction of potent antiretroviral therapy (ART), invasive aspergillosis was an important cause of morbidity and mortality in patients with AIDS. In the present day, this infection is now rarely seen in this patient population except among those with advanced immunosuppression.

This topic will address the diagnosis and treatment of aspergillosis. The epidemiology and clinical manifestations of aspergillosis in HIV-infected patients are discussed elsewhere. (See "Epidemiology and clinical manifestations of pulmonary aspergillosis and invasive disease in HIV-infected patients".)

GENERAL BACKGROUND

Invasive aspergillosis is an uncommon, but life-threatening, opportunistic infection in patients with AIDS [1]. Invasive pulmonary aspergillosis is characterized by fungal invasion into the lung parenchyma with pneumonia, with or without dissemination to other organ systems, including the central nervous system, heart, kidney, and sinuses. The majority of patients present with fever, dyspnea and cough [1]. A wide spectrum of radiographic changes can be seen, including cavitary lesions, focal alveolar infiltrates, or diffuse interstitial infiltrates. (See "Epidemiology and clinical manifestations of invasive aspergillosis".)

APPROACH TO DIAGNOSIS

The diagnosis of invasive aspergillosis rests upon:

Isolation of the organism

                                 

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Literature review current through: Nov 2016. | This topic last updated: Fri May 13 00:00:00 GMT+00:00 2016.
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