[Invasive aspergillosis].
Invasive aspergillosis remains a life-threatening complication in immunocompromised patients. The pulmonary involvement by the aspergillosis is the most common setting. The dissemination of the disease is correlated with the worse prognosis. The overall improvement of the prognosis needs a global diagnostic and therapeutic strategy. In neutropenic patients (mostly at risk of invasive aspergillosis), an early diagnosis can be achieved by systematic use of thoracic CT scan to search halo sign (that seems to be quite specific of the diagnosis in this setting). The early initiation of the antifungal treatment (conventional or liposomal amphotericin or new azole compounds) could be combined with a surgical approach if necessary. This approach could be able to improve the prognosis of aspergillosis. However, the outcome of these patients remains also correlated to the underlying disease.
Caillot
D
D
Service d'hématologie clinique Centre hospitalier universitaire Hôpital Le Bocage 21034 Dijon. denis.caillot8@fnac.net
Mannone
L
L
Kara-Slimane
F
F
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000628:therapy; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis / Q000628:therapy; D001992:Bronchoalveolar Lavage Fluid; D003937:Diagnosis, Differential; D004338:Drug Combinations; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D017964:Itraconazole / Q000627:therapeutic use; D020953:Neuroaspergillosis / Q000175:diagnosis / Q000628:therapy; D009503:Neutropenia / Q000150:complications; D010713:Phosphatidylcholines / Q000627:therapeutic use; D010715:Phosphatidylglycerols / Q000627:therapeutic use; D011183:Postoperative Complications; D011379:Prognosis; D013902:Radiography, Thoracic; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D017964:Itraconazole; D000666:Amphotericin B