Welcome to Cross-Canada Paediatric - Respiratory Residency Rounds
Page 11 / Case 10.03


There are more than 250 species of aspergillus, among them being:
– A.fumigatus
– A.flavus
– A.terreus
– A niger.
They are acquired through respiratory route. They are increased in damp cellars, potted plants, and dusty environments They rarely cause a disease in normal host. Risk of infection is increased with defects of macrophage or neutrophil.

IPA is a major cause of morbidity and mortality in the immunocompromised host (ICP). Invasion usually involves the pulmonary, sinus, cerebral and coetaneous sites.

The hallmark of IPA is angio-invasion IPA take many forms including:
– Acute necrotizing Broncho-pneumonia
– Hemorrhagic pulmonary infarction
– Lung abscess
– Lobar pneumonia
– Solitary nodulesa
– Bronchitis, and pleural effusion.
Abassi et al clinical inf dis 99

– 6.8% among malignancy. A.H.Groll et al mycosis 42,1999
– 8% among AML. M. Cornet et al 02,J of hospital infection 2002
– Incubation periods : unknown
– Average hospitalization: in USA in 1996, 17.3 days, cost $62,426,000. Erik J .Dubach et al clinical inf dis 2000
– Transmission by direct inoculation of skin abrasion or wounds is less likely. Person to person spread does not occur!

Highest risk:
– Hematological malignancies, organ transplants, HIV? Rapid neutrophil recovery might be a risk factor for sever pulmonary complication "hemoptysis" G.Todeschini et al, Eur J clin investigation 99
– BMT 32%, hematologic disease 29%, solid organ transplants 9%, AIDS 8% Patterson Thomas et al Med 2000( Baltimore), 2000

Clinical signs:

Non specific but always include fever (refractory fever to broad spectrum antibiotic therapy). Hemoptysis is not un common.

NEXT PAGE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Archives / Contact us