[Invasive aspergillosis in Castilla y Leon and Cantabria: years 1998 and 1999].
BACKGROUND
Invasive aspergillosis (IA) is a life-threatening mycosis showing a fast clinical course, affecting immunosupressed people particularly patients suffering leukemia or following organ transplantation programs. The aim of this work is to show epidemiologycal concerns about IA in Castilla y Leon and Cantabria: the disease's incidence, the main clinical presentations, the underlaying diseases and diagnostic rules in the laboratory.


METHODS
50 cases of IA were obtained from the countries of Castilla y Leon and Cantabria in a two-years (1998-1999) retrospective study. Epidemiology, clinical and diagnostic features including the 14 main institutions were registered and accounted in a single data base.


RESULTS
The majority of IA cases were recorded in major institutions possessing haematology units or organ transplantation programs. Invasive pulmonary aspergillosis was the main feature (39/50 cases) showing serious underlying diseases (25/50 cases) or following organ transplantation programs (15/50 cases). Certain diagnosis was obtained for only ten cases of invasive pulmonary aspergillosis and eleven cases of extrapulmonary stages of IA. In a high number of cases (44/50 cases) conventional microbiological procedures (42/50 showing positive cultures) were developed. Serology investigations were undertaken in eight cases. Serological issues relying on anti-Aspergillus antibodies showed no diagnostic value. Aspergillus fumigatus was the most common species involved in IA (33/44 cases).


CONCLUSIONS
A low incidence of the disease in this country was reported: with 50 cases in 14 hospital institutions during a two-year period. We observed most cases in large hospital centres performing transplant operations. Invasive pulmonary aspergillosis was the main clinical setting in immunosupressed patients. Microbiology diagnostic issues relied on conventional methods in particularly on culture.
López-Medrano
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Sección de Microbiología, Hospital del Bierzo, C/ la Dehesa-Fuentesnuevas, 24411, Ponferrada, León, España. ramirozlm@teleline.es