There are more than 250 species of aspergillus, among them being:
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.
INVASIVE PULMONARY ASPERGELLOSIS (IPA)
IPA is a major cause of morbidity and mortality in the immunocompromised host (ICP). Invasion usually involves the pulmonary, sinus, cerebral and coetaneous sites.
hallmark of IPA is angio-invasion IPA
take many forms including:
Acute necrotizing Broncho-pneumonia
Hemorrhagic pulmonary infarction
Bronchitis, and pleural effusion.
Abassi et al clinical inf dis 99
EPIDEMIOLOGY OF IPA
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!
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
Non specific but always include fever (refractory fever to broad spectrum antibiotic therapy). Hemoptysis is not un common.