title: Invasive Aspergillosis in Neutropenic Patients with Hematological Disorders.
abstract: Between 1983-1988, 72 patients with acute leukemia and 4 with aplastic anemia were treated in the Hematology Unit of The Chaim Sheba Medical Center. Ten patients with acute leukemia developed invasive pulmonary aspergillosis and 2 with aplastic anemia developed invasive aspergillosis of the nose and paranasal sinuses. These infections were diagnosed during a period of profound neutropenia while these patients were receiving broad spectrum antibiotics. The diagnosis of pulmonary aspergillosis was based on positive sputum cultures in 4 cases and on the appearance of typical clinical and radiologic features in six. In 2 culture-positive and in one culture-negative patient, the diagnosis was confirmed at autopsy. Thus, the diagnosis was definitive in 5 patients and probable in the remaining five patients. The 5 patients who achieved remission responded to antifungal treatment and recovered, while of the 5 who eventually died from the fungal infection, 4 did not achieve remission, and one died while in complete remission. In the 2 patients with aplastic anemia, aspergillosis was detected in cultures from necrotic nasal tissue. Both patients remained neutropenic, failed to respond to antifungal treatment and died within a short time after diagnosis. From this experience it appears that invasive aspergillosis in neutropenic patients is potentially curable if treated early by amphotericin B, provided that the neutrophil count recovers.
authors.affiliation: a Institute of Hematology, The Chaim Sheba Medical Center, Tel Hashomer, and The Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Shpilberg
authors.affiliation: a Institute of Hematology, The Chaim Sheba Medical Center, Tel Hashomer, and The Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Douer
authors.affiliation: b Microbiology Laboratory, The Chaim Sheba Medical Center, Tel Hashomer, and The Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Goldschmied-Reouven
authors.affiliation: b Microbiology Laboratory, The Chaim Sheba Medical Center, Tel Hashomer, and The Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: C
authors.initials: C
authors.lastname: Block
authors.affiliation: a Institute of Hematology, The Chaim Sheba Medical Center, Tel Hashomer, and The Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Ben-Bassat
authors.affiliation: a Institute of Hematology, The Chaim Sheba Medical Center, Tel Hashomer, and The Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Ramot
keywords: Invasive aspergillosis; acute leukemia; aplastic anemia; neutropenia