title: Invasive Aspergillosis: Epidemiology, Clinical Aspects, and Treatment.
abstract: Invasive aspergillosis remains an often fatal, difficult-to treat infection in immunocompromised patients. Patients not classically defined as immunocompromised, especially those in an intensive care unit setting, also develop invasive aspergillosis. Clinical clues suggesting angioinvasion and radiographic modalities, especially computed tomographic scans, combined with newer non-culture-based diagnostic techniques, have allowed earlier recognition of invasive aspergillosis. Although mortality remains high, it has greatly decreased over the past 15 years. Voriconazole has supplanted amphotericin B, with its various toxicities, as primary treatment for invasive aspergillosis. Combination therapy with voriconazole and an echinocandin for initial therapy, based on results from a recent controlled clinical trial, could become the standard of care in high-risk patients.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Gregg
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kauffman
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000453:epidemiology*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B; D065819:Voriconazole