[Invasive aspergillosis on a surgical intensive care unit].
From 1-1-1995 until 1-3-2000 4777 patients were treated in a surgical intensive care unit. 12 patients (10 male/2 female, mean age 58 years) suffered from invasive aspergillosis. One patient had a purulent descending mediastinitis with evidence of Aspergillus fumigatus in the mediastinum and in both pleural cavities. One patient got a right upper lobectomie in cause of an aspergilloma. In 10 patients a broncho-alveolar aspergillosis was proved by at least two cultures from broncho-alveolar lavage (BAL) and biopsies. All our patients had a mean of 12.8 risk factors for systemic mycoses. The patients suffered from following underlying diseases: 3 x carcinoma of the esophagus (chemotherapy + radiation), 2 x ulcerative colitis, 1 x rupture of the aorta with insufficiency of the liver, 1 x acute leucosis and 1 x purulent mediastinitis. The therapy was based on infusion with amphotericin B up to 1.5 mg/kg/day in combination with flucytosine or itraconazole. In 4 patients inhalation of amphotericin B aerosol was applied. After therapeutic failure of amphotericin B-therapy 3 patients got voriconazole according to a study protocol. 10 patients died, 7 of them from their underlying disease.
Kujath
P
P
Klinik für Chirurgie, Universitätsklinikum Lübeck, Germany.
Klempien
I
I
Muhl
E
E
Kämmerer
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000382:microbiology*; D001232:Aspergillus fumigatus; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use; D012307:Risk Factors; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D000666:Amphotericin B; D005437:Flucytosine; D065819:Voriconazole