Skip to main content
SpringerLink
Log in

Aspergillosis

  • Current Topic: Review
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

Aspergillus spores are ubiquitous in the environment and may become concentrated in hospital ventilation systems. Colonization in normal hosts can lead to allergic diseases ranging from asthma to allergic bronchopulmonary aspergillosis. Normal hosts rarely develop invasive disease, which is primarily an infection of severely immunocompromised patients. The major predisposing factors for infection include prolonged neutropenia, chronic administration of adrenal corticosteroids, the insertion of prosthetic devices, and tissue damage due to prior infection or trauma. SinceAspergillus spp. are respiratory pathogens, the most common form of infection is pneumonia followed by sinusitis. Patients with preexistant cavitary disease may develop noninvasive aspergillomas. Most infections are caused byAspergillus fumigatus. The organism is capable of invading across all natural barriers, including cartilage and bone. It has a propensity for invading blood vessels causing thrombosis and infarction. The diagnosis of pulmonary infection is usually difficult to establish because the organism is seldom cultured from sputum and can represent contamination in some cases. Therapy in immunocompromised hosts is less than satisfactory and amphotericin B is the only agent with significant activity. There is anecdotal evidence to suggest that the addition of 5-fluorocytosine to amphotericin B may be beneficial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hinson, K. F. W., Moon, A. J., Plummer, N. S. Broncho-pulmonary aspergillosis: a review and a report of eight new cases. Thorax 1952, 7: 317–333.

    PubMed  Google Scholar 

  2. Rinaldi, M. G. Invasive aspergillosis. Reviews of Infectious Diseases 1983, 5: 1061–1077.

    PubMed  Google Scholar 

  3. Raper, K. B., Fennell, D. I. The genusAspergillus. Williams & Wilkins, Baltimore, 1965, p. 1–686.

    Google Scholar 

  4. Jokinen, K., Pajarre, S., Palva, A., Sipila, P. Mycotic flora in tonsils and adenoids a microbiological and histological evaluation. Journal of Laryngology and Otology 1976, 90: 945–952.

    PubMed  Google Scholar 

  5. Cohen, R., Roth, F. J., Delgado, E., Ahearn, D. G., Kalser, M. H. Fungal flora of the normal human small and large intestine. New England Journal of Medicine 1969, 280:638–641.

    PubMed  Google Scholar 

  6. Pepys, J., Riddell, R. W., Citron, K. M., Clayton, Y. M., Short, E. I. Clinical and immunologic significance ofAspergillus fumigatus in the sputum. American Review of Respiratory Disease 1959, 80: 167–180.

    PubMed  Google Scholar 

  7. Weems, J. J., Andremont, A., Davis, B. J., Tancsrede, C. H., Guiguet, M., Padhye, A. A., Squinazi, F., Martone, W. J. Pseudoepidemic of aspergillosis after development of pulmonary infiltrates in a group of bone marrow transplant patients. Journal of Clinical Microbiology 1987, 25: 1459–1462.

    PubMed  Google Scholar 

  8. Perraud, M., Piens, M. A., Nicoloyannis, N., Girard, P., Sepetjan, M., Garin, J. P. Invasive nosocomial pulmonary aspergillosis: risk factors and hospital building works. Epidemiology and Infection 1987, 99: 407–412.

    PubMed  Google Scholar 

  9. Aisner, J., Schimpff, S. C., Bennett, J. E., Young, V. M., Wiernik, P. H. Aspergillus infections in cancer patients. Journal of the American Medical Association 1976, 235: 411–412.

    PubMed  Google Scholar 

  10. Ruutu, P., Valtonen, V., Titanen, L., Elonen, E., Volin, L., Veijalainen, P., Ruutu, T. An outbreak of invasive aspergillosis in a haematologic unit. Scandinavian Journal of Infectious Diseases 1987, 19: 347–351.

    PubMed  Google Scholar 

  11. Sherertz, R. J., Belani, A., Kramer, B. S., Elfenbein, G. J., Weiner, R. S., Sullivan, M. L., Thomas, R. G., Samas, G. P. Impact of air filtration on nosocomialAspergillus infections. American Journal of Medicine 1897, 83: 709–718.

    Google Scholar 

  12. Rotstein, C., Cummings, K. M., Tidings, J., Killion, K., Powell, E., Gustafson, T. L., Higby, D. An outbreak of invasive aspergillosis among allogeneic bone marrow transplants: a case-control study. Infection Control 1985, 6: 347–355.

    PubMed  Google Scholar 

  13. Arnow, P. M., Andersen, R. L., Mainous, P. D., Smith, E. J. Pulmonary aspergillosis during hospital renovation. American Review of Respiratory Disease 1978, 118: 49–53.

    PubMed  Google Scholar 

  14. Sarubbi, F. A., Kopf, H. B., Wilson, M. B., McGinnis, M. R., Rutala, W. A. Increased recovery ofAspergillus flavus from respiratory specimens during hospital construction. American Review of Respiratory Disease 1982, 125: 33–38.

    PubMed  Google Scholar 

  15. Kyriakides, G. K., Zinneman, H. H., Hall, W. H., Arora, V. K., Lifton, J., DeWolf, W. C., Miller, J. Immunologic monitoring and aspergillosis in renal transplant patients. American Journal of Surgery 1976, 131: 246–252.

    PubMed  Google Scholar 

  16. Lentio, J. R., Rosenkranz, M. A., Michaels, J. A., Kurup, V. P., Rose, H. D., Rytel, M. W. Nosocomial aspergillosis: a retrospective review of airborne disease secondary to road construction and contaminated air conditioners. American Journal of Epidemiology 1982, 116: 430–437.

    PubMed  Google Scholar 

  17. Opal, S. M., Asp, A. A., Cannady, P. B., Morse, P. L., Burton, L. J., Hammer, P. G. Efficacy of infection measures during a nosocomial outbreak of disseminated aspergillosis associated with hospital construction. Journal of Infectious Diseases 1986, 153: 634–637.

    PubMed  Google Scholar 

  18. Rhame, F. S., Streifel, A., Stevens, P., et al. Endemic aspergillus airbone spore levels are a major risk factor for aspergillosis in bone marrow transplant patients. 25th Interscience Conference on Antimicrobial Agents and Chemotherapy, Minneapolis, 1985. American Society for Microbiology, Washington, DC, 1985, Abstract 147.

    Google Scholar 

  19. Khardori, N. Host parasite interactions in fungal infections. European Journal of Clinical Microbiology & Infectious Diseases 1989, 8: 331–352.

    Google Scholar 

  20. Schaffner, A., Douglas, H., Braude, A. Selective protection againstConidia by mononuclear and againstMycelia by polymorphonuclear phagocytes in resistance toAspergillus. Journal of Clinical Investigation 1982, 69: 617–619.

    PubMed  Google Scholar 

  21. Levitz, S. M., Diamond, R. D. Changing patterns of aspergillosis infections. Advances in Internal Medicine 1984, 30: 153–174.

    PubMed  Google Scholar 

  22. Rohatgi, P. K., Rohatgi, N. B. Clinical spectrum of pulmonary aspergillosis. Southern Medical Journal 1984, 77: 1291–1301.

    PubMed  Google Scholar 

  23. Klein, D. L., Gamsu, G. Thoracic manifestations of aspergillosis. American Journal of Roentgenology 1980, 134: 543–552.

    PubMed  Google Scholar 

  24. Than, K. M., Naing, K. S., Min, M. Otomycosis in Burma, and its treatment. American Journal of Tropical Medicine and Hygiene 1980, 29: 620–623.

    PubMed  Google Scholar 

  25. Mugliston, T., O'Donoghue, G. Otomycosis — a continuing problem. Journal of Laryngology and Otology 1985, 99: 327–333.

    PubMed  Google Scholar 

  26. Landau, J. W., Newcomer, V. D., Schulz, J. Aspergillosis report of two instances in children associated with acute leukemia and review of the pertinent literature. Mycopathologia 1963, 20: 177–224.

    Google Scholar 

  27. Myers, J. T., Dunn, A. D. Aspergillus infection of the hand. Journal of the American Medical Association 1930, 95: 794–796.

    Google Scholar 

  28. Cahill, K. M., El Mofty, A. M., Kawaguchi, T. P. Primary cutaneous aspergillosis. Archives of Dermatology 1967, 96: 545–547.

    PubMed  Google Scholar 

  29. Cheetham, H. D. Subcutaneous infection due toAspergillus terreus. Journal of Clinical Pathology 1964, 17: 251–253.

    PubMed  Google Scholar 

  30. Mahgoub, S., Ismail, S. A., Hanssan, A. M. Cervical lymphadenopathy caused byAspergillus terreus. British Medical Journal 1969, 1: 689–690.

    PubMed  Google Scholar 

  31. Bruck, H. M., Nash, G., Pruitt, B. A. Opportunistic fungal infection of the burn wound with phycomycetes andAspergillus. Archives of Surgery 1971, 102: 476–482.

    PubMed  Google Scholar 

  32. Stone, H. H., Cuzzell, J. Z., Kolb, L. D., Moskowitz, M. S., McGowan, J. E. Aspergillus infection of the burn wound. Journal of Trauma 1979, 19: 765–767.

    PubMed  Google Scholar 

  33. Axelsson, H., Carlsoo, B., Weibring, J., Winblad, B. Aspergillosis of the maxillary sinus. Acta Oto-Laryngologica 1978, 86: 303–308.

    PubMed  Google Scholar 

  34. Lowe, J., Bradley, J. Cerebral and orbitalAspergillus infection due to invasive aspergillosis of ethmoid sinus. Journal of Clinical Pathology 1986, 39: 774–778.

    PubMed  Google Scholar 

  35. Rodriguez, V., Bardwil, J. M., Bodey, G. P. Primary aspergilloma cured with amphotericin B. Southern Medical Journal 1971, 64: 396–398.

    PubMed  Google Scholar 

  36. Beck-Mannagetta, J., Necek, D. Radiologic findings in aspergillosis of the maxillary sinus. Oral Surgery, Oral Medicine, Oral Pathology 1986, 62: 345–349.

    Google Scholar 

  37. Beck-Mannagetta, J., Pohla, H. Zinkoxidhaltiges Wurzelfüllmaterial — eine Ursache der Kieferhöhlen-Aspergillose. In: Watzek, G., Matejka, M. (ed.): Erkrankungen der Kieferhöhle. Springer Verlag, Wien, 1986, p. 217–224.

    Google Scholar 

  38. Leon-Kindberg, M., Parat, M., Netter, H. Tumeur mycosique du poumon (aspergillose pulmonaire primitive pseudocancereuse). Presse Médicale 1936, 44: 1834–1836.

    Google Scholar 

  39. MacPhearson, P. Pulmonary aspergillosis in argyll. British Journal of Diseases of the Chest 1965, 59: 148–151.

    PubMed  Google Scholar 

  40. Varkey, B., Rose, H. D. Pulmonary aspergilloma. American Journal of Medicine 1976, 61: 626–631.

    PubMed  Google Scholar 

  41. Fahen, P. J., Utell, M. J., Hyde, R. W. Spontaneous lysis of mycetomas after acute cavitating lung disease. American Review of Respiratory Diseases 1981, 123: 336–339.

    Google Scholar 

  42. Riley, E. A., Tennenbaum, J. Pulmonary aspergilloma or intracavitary fungus ball. Annals of Internal Medicine 1962, 56: 896–909.

    PubMed  Google Scholar 

  43. Rafferty, P., Biggs, B., Crompton, G. K., Grant, I. W. B. What happens to patients with pulmonary aspergilloma? Analysis of 23 cases. Thorax 1983, 38: 579–583.

    Google Scholar 

  44. Faulkner, S. L., Vernon, R., Brown, P. P., Fisher, R. D., Bender, H. W. Hemoptysis and pulmonary aspergilloma: operative versus nonoperative treatment. Annals of Thoracic Surgery 1978, 25: 389–392.

    PubMed  Google Scholar 

  45. Hargis, J. L., Bone, R. C., Stewart, J., Rector, N., Hiller, F. C. Intracavitary amphotericin B in the treatment of symptomatic pulmonary aspergillomas. American Journal of Medicine 1980, 68: 389–394.

    PubMed  Google Scholar 

  46. Krakowka, P., Rowinska, E., Halweg, H. Infection of the pleura byAspergillus fumigatus. Thorax 1970, 25: 245–253.

    PubMed  Google Scholar 

  47. Parry, M. F., Coughlin, F. R., Zambetti, F. X. Aspergillus empyema. Chest 1982, 81: 768–770.

    PubMed  Google Scholar 

  48. Sawasaki, H., Horie, K., Yamada, M. Bronchial stump aspergillosis: experimental and clinical study. Journal of Thoracic and Cardiovascular Surgery 1969, 58: 198–208.

    PubMed  Google Scholar 

  49. Hillerdal, G. Pulmonary aspergillus infection invading the pleura. Thorax 1981, 36: 745–751.

    PubMed  Google Scholar 

  50. Sakamoto, S., Ogata, J., Sakazaki, Y., Ikegami, K. Fungus ball formation ofAspergillus in the bladder: an unusual case report. European Urology 1978, 4: 388–389.

    PubMed  Google Scholar 

  51. Bibler, M. R., Gianis, J. T. Acute ureteral colic from an obstructing renal aspergilloma. Reviews of Infectious Diseases 1987, 9: 790–794.

    PubMed  Google Scholar 

  52. Flechner, S. M., McAninch, J. W. Aspergillosis of the urinary tract: ascending route of infection and evolving patterns of disease. The Journal of Urology 1981, 125: 598–601.

    PubMed  Google Scholar 

  53. Arfania, D., Everett, E. D., Nolph, K. D., Rubin, J. Uncommon causes of peritonitis in patients undergoing peritoneal dialysis. Archives of Internal Medicine 1981, 141: 61–64.

    PubMed  Google Scholar 

  54. Gage, A. A., Dean, D. C., Schimert, G., Minsley, N. Aspergillus infection after cardiac surgery. Archives of Surgery 1970, 101: 384–387.

    PubMed  Google Scholar 

  55. Petheram, I. S., Seal, R. M. E. Aspergillus prosthetic valve endocarditis. Thorax 1976, 31: 380–390.

    PubMed  Google Scholar 

  56. Karam, G. H., Griffin, F. M. Invasive pulmonary aspergillosis in nonimmunocompromised nonneutropenic hosts. Reviews of Infectious Diseases 1986, 8: 357–363.

    PubMed  Google Scholar 

  57. Ahmad, M., Weinstein, A. J., Hughes, J. A., Cosgrove, D. E. Granulomatous mediastinitis due toAspergillus flavus in a nonimmunosuppressed patient. American Journal of Medicine 1981, 70: 887–890.

    PubMed  Google Scholar 

  58. Murata, K., Sekigawa, T., Sakamoto, T., Yamazaki, T., Torizuka, K. Opportunistic esophagitis caused byAspergillus fumigatus. Radiation Medicine 1984, 2: 24–26.

    PubMed  Google Scholar 

  59. Kheir, S. M., Flint, A., Moss, J. A. Primary aspergillosis of the larynx simulating carcinoma. Human Pathology 1983, 14: 184–186.

    PubMed  Google Scholar 

  60. Brandt, S. J., Thompson, R. L., Wenzel, R. P. Mycotic pseudoaneurysm of an aortic bypass graft and contiguous vertebral osteomyelitis due toAspergillus fumigatus. American Journal of Medicine 1985, 79: 259–262.

    PubMed  Google Scholar 

  61. Williams, K., Walton, R. L., Bunkis, J. Aspergillus colonization associated with bilateral silicone mammary implants. Plastic Reconstructive Surgery 1983, 71: 260–261.

    Google Scholar 

  62. Frank, L., Alton, O. M. Aspergillosis: a case of post-operative skin infection. Journal of the American Medical Association 1933, 100: 2007–2008.

    Google Scholar 

  63. Eisenberg, R. L., Hedgeoek, M. W., Shanser, J. D. Aspergillus mycetoma of the renal pelvis associated with ureteropelvic junction obstruction. The Journal of Urology 1977, 118: 466–467.

    PubMed  Google Scholar 

  64. Corrall, C. J., Merz, W. G., Rekedal, K., Hughes, W. T. Aspergillus osteomyelitis in an immunocompetent adolescent: a case report and review of the literature. Pediatrics 1982, 70: 455–461.

    PubMed  Google Scholar 

  65. Swensson, E. E., Willman, V. L., Peterson, G. J. Acute aortic occulsion from aspergillosis in a healthy patient with survival. Journal of Vascular Surgery 1986, 4: 187–191.

    PubMed  Google Scholar 

  66. Sihota, R., Agarwal, H. C., Grover, A. K., Sood, N. N. Aspergillus endophthalmitis. British Journal of Ophthalmology 1987, 71: 611–613.

    PubMed  Google Scholar 

  67. Wagner, D. K., Varkey, B., Sheth, N. K., DaMert, G. J. Epidural abscess, vertebral destruction and paraplegia caused by extending infection from an aspergilloma. American Journal of Medicine 1985, 78: 518–522.

    PubMed  Google Scholar 

  68. Ven de Wyngaert, F. A., Sindic, C. J. M., Rousseau, J. J., Fernandes Xavier, F. G., Brucher, J. M., Laterre, E. C. Spinal arachnoiditis due toAspergillus meningitis in a previously healthy patient. Journal of Neurology 1986, 233: 41–43.

    PubMed  Google Scholar 

  69. Fernando, S. S. E., Lauer, C. S. Aspergillus fumigatus infection of the optic nerve with mycotic arteritis of cerebral vessels. Histopathology 1982, 6: 227–234.

    PubMed  Google Scholar 

  70. Fuchs, H. A., Evans, R. M., Gregg, C. R. Invasive aspergillosis of the sphenoid sinus manifested as a pituitary tumor. Southern Medical Journal 1985, 78: 1364–1367.

    Google Scholar 

  71. Sekhar, L. N., Dujovny, M., Rao, G. R. Carotid-cavernous sinus thrombosis caused byAspergillus fumigatus. Journal of Neurosurgery 1980, 52: 120–125.

    PubMed  Google Scholar 

  72. Yanai, Y., Wakao, T., Fukamachi, A., Kunimine, H. Intracranial granuloma caused byAspergillus fumigatus. Surgical Neurology 1985. 23: 597–604.

    PubMed  Google Scholar 

  73. Zellner, S. R., Selby, J. B., Loughrin, J. J. Aspergillus: an unusual presentation. American Review of Respiratory Disease 1969, 100: 217–220.

    PubMed  Google Scholar 

  74. Brown, E., Freedman, S., Arbeit, R., Come, S. Invasive pulmonary aspergillosis in an apparently non-immunocompromised host. American Journal of Medicine 1980, 69: 624–627.

    PubMed  Google Scholar 

  75. Cooper, J. A. D., Weinbaum, D. L., Aldrich, T. K., Mandell, G. L. Invasive aspergillosis of the lung and pericardium in a nonimmunocompromised 33 year old man. American Journal of Medicine 1981, 71: 903–907.

    PubMed  Google Scholar 

  76. D'Silva, H., Furke, J. F., Cho, S. Y. Disseminated aspergillosis in a presumably immunocompetent host. Journal of the American Medical Association 1982, 248: 1465–1467.

    PubMed  Google Scholar 

  77. Vedder, J. S., Schorr, W. F. Primary disseminated pulmonary aspergillosis with metastatic skin nodules. Successful treatment with inhalation nystatin therapy. Journal of the American Medical Association 1969, 209: 1191–1195.

    PubMed  Google Scholar 

  78. Smith, G. W., Walker, D. H. Disseminated infection withAspergillus flavus in an alcoholic patient. Southern Medical Journal 1982, 75: 1148–1150.

    PubMed  Google Scholar 

  79. Guidotti, T. L., Luetzeler, J., Di Sant'Agnese, P. A., Escaro, D. U. Fatal disseminated aspergillosis in a previously well young adult with cystic fibrosis. American Journal of the Medical Sciences 1982, 283: 157–160.

    PubMed  Google Scholar 

  80. Hutter, R. V. P., Lieberman, P. H., Collins, H. S. Aspergillosis in a cancer hospital. Cancer 1964, 17: 747–756.

    PubMed  Google Scholar 

  81. Schumacher, H. R., Ginns, D. A., Warren, W. J. Fungus infection complicating leukemia. American Journal of Medical Sciences 1964, 247: 313–323.

    Google Scholar 

  82. Baker, R. D. Leukopenia and therapy in leukemia as factors predisposing to fatal mycoses: mucormycosis, aspergillosis, and cryptococcosis. American Journal of Clinical Pathology 1962, 37: 358–373.

    PubMed  Google Scholar 

  83. Meyer, R. D., Young, L. S., Armstrong, D., Yu, B. Aspergillosis complicating neoplastic disease. American Journal of Medicine 1973, 54: 6–54.

    PubMed  Google Scholar 

  84. Fisher, B. D., Armstrong, D., Yu, B., Gold, J. W. M. Invasive aspergillosis: progress in early diagnosis and treatment. American Journal of Medicine 1981, 71: 571–577.

    PubMed  Google Scholar 

  85. Carbone, P. P., Sabesin, S. M., Sidransky, H., Frei, E. Secondary aspergillosis. Annals of Internal Medicine 1964, 60: 556–567.

    PubMed  Google Scholar 

  86. Young, R. C., Bennett, J. E., Vogel, C. L., Carbone, P. P., DeVita, V. T. Aspergillosis: the spectrum of the disease in 98 patients. Medicine 1970, 49: 147–173.

    PubMed  Google Scholar 

  87. Bodey, G. P. The emergence of fungi as major hospital pathogens. Journal of Hospital Infection 1988, 11: 411–426.

    PubMed  Google Scholar 

  88. Gerson, S. L., Talbot, G. H., Lusk, E., Hurwitz, S., Strom, B. L., Cassileth, P. A. Invasive pulmonary aspergillosis in adult acute leukemia: clinical clues to its diagnosis. Journal of Clinical Oncology 1985, 3: 1109–1116.

    PubMed  Google Scholar 

  89. Gerson, S. L., Talbot, G. H., Hurwitz, S., Strom, B. L., Lusk, E. J., Cassileth, P. A. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Annals of Internal Medicine 1984: 100: 345–351.

    PubMed  Google Scholar 

  90. Bach, M. C., Adler, J. L., Breman, J., P'eng, F., Sahyoun, A., Schlesinger, R. M., Madras, P., Monaco, A. P. Influence of rejection therapy on fungal and nocardial infections in renal-transplant recipients. Lancet 1973, i: 180–184.

    Google Scholar 

  91. Weiland, D., Ferguson, R. M., Peterson, P. K., Snover, D. C., Simmons, R. L., Najarian, J. S. Aspergillosis in 25 renal transplant patients. Annals of Surgery 1983, 198: 622–629.

    PubMed  Google Scholar 

  92. Peterson, P. K., Balfour, H. H., Fryd, D. S., Ferguson, R. M., Simmons, R. L. Fever in renal transplant recipients: causes, prognostic significance and changing patterns at the University of Minnesota Hospital. American Journal of Medicine 1981, 71: 345–351.

    PubMed  Google Scholar 

  93. Gustafson, T. L., Schaffner, W., Lavely, G. B., Stratton, C. W., Johnson, H. K., Hutcheson, R. H. Invasive aspergillosis in renal transplant recipients: correlation with corticosteroid therapy. Journal of Infectious Diseases 1983, 148: 230–238.

    PubMed  Google Scholar 

  94. Scroggs, M. W., Wolfe, J. A., Bollinger, R. R., Sanfilippo, F. Causes of death in renal transplant recipients: a review of autopsy findings from 1966 through 1985. Archives of Pathology and Laboratory Medicine 1987, 111: 983–987.

    PubMed  Google Scholar 

  95. Watson, J. G. Problems of infection after bone marrow transplantation. Journal of Clinical Pathology 1983, 36: 683–692.

    PubMed  Google Scholar 

  96. Allan, B. T., Patton, D., Ramsey, N. K. C., Day, D. L. Pulmonary fungal infections after bone marrow transplantation. Pediatric Radiology 1988, 18: 118–122.

    PubMed  Google Scholar 

  97. Winston, D. J., Gale, R. P., Meyer, D. V., Young, L. S. Infectious complications of human bone marrow transplantation. Medicine 1979, 58: 1–31.

    PubMed  Google Scholar 

  98. Myers, J. K., Atkinson, K. Infection in bone marrow transplantation. Clinics in Haematology 1983, 12: 791–811.

    PubMed  Google Scholar 

  99. Wingard, J. R., Beals, S. U., Santos, G. W., Merz, W. G., Saral, R. Aspergillus infections in bone marrow transplant recipients. Bone Marrow Transplantation 1987, 2: 175–181.

    PubMed  Google Scholar 

  100. Bodey, G. P. Fungal infections. In: Lode, H., Huhn, D., Molzohm, M. (ed.): Infections in transplant patients. Thieme, Stuttgart, 1987, p. 134–151.

    Google Scholar 

  101. Britt, R. H., Enzmann, D. R., Remington, J. S. Intracranial infection in cardiac transplant recipients. Annals of Neurology 1981, 9: 107–119.

    Google Scholar 

  102. Kusne, S., Drummer, J. S., Singh, N., Iwatsuki, S., Makowka, L., Esquivel, C., Tzakis, A. G., Starzl, T. E., Ho, M. Infections after liver transplantation: an analysis of 101 consecutive cases. Medicine 1988, 67: 132–143.

    PubMed  Google Scholar 

  103. Wajszczuk, C. P., Dummer, J. S., Ho, M., Van Thiel, D. H., Starzl, T. E., Iwatsuki, S., Shaw, B. Fungal infections in liver transplant recipients. Transplantation 1985, 40: 347–353.

    PubMed  Google Scholar 

  104. Rose, H. D., Varkey, B. Deep mycotic infection in the hospitalized adult: a study of 123 patients. Medicine 1975, 54: 499–507.

    PubMed  Google Scholar 

  105. Wright, S. H., Czaja, A. J., Katz, R. S., Soloway, R. D. systemic mycosis complicating high dose corticosteroid treatment of chronic active liver disease. American Journal Gastroenterology 1980, 74: 428–432.

    Google Scholar 

  106. Pillar, V. K. G., Wilson, D. M., Ing, T. S., Kark, R. M. Fungus infection in steroid-trated systemic lupus erythematosus. Journal of the American Medical Association 1968, 205: 261–265.

    PubMed  Google Scholar 

  107. Hellmann, D. B., Petri, M., Whiting-O'Keefe, Q. Fatal infections in systemic lupus erythematosus: the role of opportunistic organisms. Medicine 1987, 66: 341–348.

    PubMed  Google Scholar 

  108. Winterbauer, R. H., Kraemer, K. G. The infectious complications of sarcoidosis: a current perspective. Archives of Internal Medicine 1976, 136: 1356–1362.

    PubMed  Google Scholar 

  109. Kaplan, J., Johns, C. J. Mycetomas in pulmonary sarcoidosis: non-surgical management. Johns Hopkins Medical Journal 1979, 145: 157–161.

    PubMed  Google Scholar 

  110. Waldhorn, R. E., Tsou, E., Kerwin, D. M. Invasive pulmonary aspergillosis associated with aspergilloma in sarcoidosis. Southern Medical Journal 1983, 76: 251–253.

    PubMed  Google Scholar 

  111. Walsh, T. J., Mendelsohn, G. Invasive aspergillosis complicating cushing's syndrome. Archives of Internal Medicine 1981, 141: 1227–1228.

    PubMed  Google Scholar 

  112. Chudwin, D. S., Wara, D. W., Cowan, M. J., Ammann, A. J. Aspergillus. Acta Paediatrica Scandinavica 1982, 71: 915–917.

    PubMed  Google Scholar 

  113. Johnston, R. B., Newman, S. L. Chronic granulomatous disease. Pediatric Clinics of North America 1977, 24: 365–376.

    PubMed  Google Scholar 

  114. Cohen, M. S., Isturiz, R. E., Malech, H. L., Root, R. K., Wilfert, C. M., Gutman, L., Buckely, R. H. Fungal infection in chronic granulomatous disease: the importance of the phagocyte in defense against fungi. American Journal of Medicine 1981, 71: 59–66.

    PubMed  Google Scholar 

  115. Fietta, A., Sacchi, F., Mangiarotti, P., Manara, G., Gialdroni Grassi, G. Defective phagocyteAspergillus killing associated with recurrent pulmonary aspergillus infections. Infection 1984, 12: 10–13.

    PubMed  Google Scholar 

  116. Chusid, M. J., Sohnle, P. G., Fink, J. N., Shea, M. L. A genetic defect of granulocyte oxidative metabolism in a man with disseminated aspergillosis. Journal of Laboratory and Clinical Medicine 1981, 97: 730–738.

    PubMed  Google Scholar 

  117. Rhine, W. D., Arvin, A. M., Stevenson, D. K. Neonatal aspergillosis: a case report and review of the literature. Clinical Pediatrics 1986, 25: 400–403.

    PubMed  Google Scholar 

  118. Lewis, M., Kallenbach, J., Ruff, P., Zaltzman, M., Abramowitz, J., Zwi, S. Invasive pulmonary aspergillosis complicating influenza A pneumonia in the previously healthy patient. Chest 1985, 87: 691–693.

    PubMed  Google Scholar 

  119. Binder, R. E., Faling, L. J., Pugatch, R. D., Mahasaen, C., Snider, G. L. Chronic necrotizing pulmonary aspergillosis: a discrete clinical entity. Medicine 1982, 00: 109–124.

    Google Scholar 

  120. Gefter, W. B., Weingard, T. R., Epstein, D. M., Ochs, R. H., Miller, W. T. “Semi-invasive” pulmonary aspergillosis. Radiology 1981, 140: 313–321.

    PubMed  Google Scholar 

  121. Pennington, J. E. Aspergillus pneumonia in hematologic malignancy: improvements in diagnosis and therapy. Archives of Internal Medicine 1977, 137: 769–771.

    PubMed  Google Scholar 

  122. Libshitz, H. I., Pagoni, J. Aspergillosis and mucormycosis: two types of opportunistic fungal pneumonia. Radiology 1981, 140: 303–306.

    Google Scholar 

  123. Curtis, A. M., Smith, G. J. W., Ravin, C. E. Air crescent sign of invasive aspergillosis. Radiology 1979, 133: 17–21.

    PubMed  Google Scholar 

  124. Reger, T. R., Visscher, D. W., Bartlett, M. S., Smith, J. W. Diagnosis of pulmonary infection caused byAspergillus: usefulness of respiratory cultures. Journal of Infectious Diseases 1985, 152: 572–576.

    PubMed  Google Scholar 

  125. Nalesnk, M. A., Myerowitz, R. L., Jenkins, R., Lenkey, J., Herbert, D. Significance ofAspergillus species isolated from respiratory secretions in the diagnosis of invasive pulmonary aspergillosis. Journal of Clinical Microbiology 1980, 11: 370–376.

    PubMed  Google Scholar 

  126. Bodey, G. P. Fungal infections complicating acute leukemia. Journal of Chronic Diseases 1966, 19: 667–687.

    PubMed  Google Scholar 

  127. Yu, V. L., Muder, R. R., Poorsattar, A. Significance of isolation ofAspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis: results from a three-year prospective study. American Journal of Medicine 1986, 81: 249–254.

    PubMed  Google Scholar 

  128. Kuhlman, J. E., Fishman, E. K., Burch, P. A., Karp, J. E., Zerhouni, E. A., Siegelman, S. S. Invasive pulmonary aspergillosis in acute leukemia: the contribution of CT to early diagnosis and aggressive management. Chest 1987, 92: 95–99.

    PubMed  Google Scholar 

  129. Sinclair, A. J., Rossof, A. H., Coltman, C. A. Recognition and successful management in pulmonary aspergillosis in leukemia. Cancer 1978, 42: 2019–2024.

    PubMed  Google Scholar 

  130. Young, R. C., Bennet, J. E. Invasive aspergillosis: absence of detectable antibody response. Annual Review of Respiratory Diseases 1971, 104: 710–716.

    Google Scholar 

  131. Gold, J. W. M., Fisher, B., Yu, B., Chein, N., Armstrong, D. Diagnosis of invasive aspergillosis by passive hemagglutination assay of antibody. Journal of Infectious Diseases 1980, 142: 87–94.

    PubMed  Google Scholar 

  132. Marier, R., Smith, W., Jansen, M., Andriole, V. T. A solid-phase radioimmunoassay for the measurement of antibody toAspergillus in invasive aspergillosis. Journal of Infection 1979, 140: 771–779.

    Google Scholar 

  133. Trull, A., Parker, J., Warren, R. E. IgG enzyme-linked immunosorbent assay for diagnosis of invasive aspergillosis: retrospective study over 15 years of transplant recipients. Journal of Clinical Pathology 1985, 38: 1045–1051.

    PubMed  Google Scholar 

  134. Schaffer, P. J., Medoff, G., Kohayashi, G. Demonstration of antigenemia by radioimmunoassay in rabbits experimentally infected withAspergillus. Journal of Infectious Diseases 1979, 139: 313–319.

    PubMed  Google Scholar 

  135. Sabetta, J. R., Miniter, P., Andriole, V. T. The diagnosis of invasive aspergillosis by an enzyme-linked immunoasorbent assay for circulating antigen. Journal of Infectious Diseases 1985, 152: 946–953.

    PubMed  Google Scholar 

  136. Dupont, B., Huber, M., Kim, S. J., Bennet, J. E. Galactomannan antigenemia and antigenuria in aspergillosis: studies in patients and experimentally infected rabbits. Journal of Infectious Diseases 1987, 155: 1–11.

    PubMed  Google Scholar 

  137. Talbot, G. H., Weiner, M. H., Gerson, S. L., Provencher, M., Hurwitz, S. Serodiagnosis of invasive aspergillosis in patients with hematologic malignancy: validation of theAspergillus fumigatus antigen radioimmunoassay. Journal of Infectious Diseases 1987, 155: 12–27.

    PubMed  Google Scholar 

  138. Weiner, M. H., Talbot, G. H., Gerson, S. L., Filice, G., Cassileth, P. A. Antigen detection in the diagnosis of invasive aspergillosis. Annuals of Internal Medicine 1983, 99: 777–782.

    Google Scholar 

  139. Andrews, C. P., Weiner, M. H. Aspergillus antigen detection in bronchoalveolar lavage fluid from patients with invasive aspergillosis and aspergillomas. American Journal Medicine 1982, 73: 372–380.

    Google Scholar 

  140. Nime, F. A., Hutchins, G. M. Oxalosis caused byAspergillus infection. Hopkins Medical Journal 1973, 133: 183–194.

    Google Scholar 

  141. Farley, M. L., Mabry, L., Munoz, L. A., Diserens, H. W. Crystals occurring in pulmonary cytology specimens: association withAspergillus infection. Acta Cytologica 1985, 29: 737–744.

    PubMed  Google Scholar 

  142. Benoit, G., De Chauvin, M. F., Cordonnier, C., Astier, A., Bernaudin, J. Oxalic acid level in bronchoalveolar lavage fluid from patients with invasive pulmonary aspergillosis. American Review of Respiratory Disease 1985, 132: 748–751.

    PubMed  Google Scholar 

  143. Rohtgi, P. K., Simon, D. B., Goldstein, R. A., Reba, R. C. Strontium-87 lung scans in pulmonary aspergillosis. American Journal of Roentgenology 1977, 129: 879–882.

    PubMed  Google Scholar 

  144. Aisner, J., Murillo, J., Schimpff, S. C., Steere, A. C. Invasive aspergillosis in acute leukemia: correlation with nose cultures and antibiotic use. Annals of Internal Medicine 1979, 90: 4–9.

    PubMed  Google Scholar 

  145. Sandford, G. R., Merz, W. G., Wingard, J. R., Charache, P., Saral, R. The value of fungal surveillance cultures as predictors of systemic fungal infections. Journal of Infectious Diseases 1980, 142: 503–509.

    PubMed  Google Scholar 

  146. Viollier, A., Peterson, D. E., De Jongh, C. A., Newman, K. A., Gray, W. C., Sutherland, J. C., Moody, M. A., Schimpff, S. C. Aspergillus sinusitis in cancer patients. Cancer 1986, 58: 366–371.

    PubMed  Google Scholar 

  147. Dreizen, S., Bodey, G. P., McCredie, K. B., Keating, M. J. Orofacial aspergillosis in acute leukemia. Oral Surgery, Oral Medicine, Oral Pathology 1985, 59: 499–504.

    Google Scholar 

  148. Prystowsky, S. D., Vogelstein, B., Ettinger, D. S., Merz, W. G., Kaizer, H., Sulica, V. I., Zinkham, W. H. Invasive aspergillosis. Medical Intelligence 1976, 295: 655–658.

    Google Scholar 

  149. Allo, M. D., Miller, J., Townsend, T., Tan, C. Primary cutaneous aspergillosis associated with Hickman intravenous catheters. New England Journal of Medicine 1987, 317: 1105–1108.

    PubMed  Google Scholar 

  150. Findaly, G. H., Roux, H. F., Simson, I. W. Skin manifestations in disseminated aspergillosis. British Journal of Dermatology 1971, 85: 94–97.

    Google Scholar 

  151. Allen, U., Smith, C. R., Prober, C. G. The value of skin biopsies in febrile, neutropenic, immunocompromised children. American Journal of Diseases of Children 1986, 140: 459–461.

    PubMed  Google Scholar 

  152. Searl, S. S., Udell, I. J., Sadun, A., Hyslop, N. E., Albert, D. M., Kenyon, K. R. Aspergillus keratitis with intraocular invasion. Ophthalmology 1981, 88: 1244–1250.

    PubMed  Google Scholar 

  153. Green, W. R., Font, R. L., Zimmerman, L. E. Aspergillosis of the orbit: report of ten cases and review of the literature. Archives of Ophthalmology 1969, 82: 302–313.

    PubMed  Google Scholar 

  154. Demicco, D. D., Reichman, R. C., Violette, E. J., Winn, W. C. Disseminated aspergillosis presenting with endophthalmitis: a case report and a review of the literature. Cancer 1984, 53: 1995–2001.

    PubMed  Google Scholar 

  155. Mohandas, S., Ahuja, G. K., Sood, V. P., Virmani, V. Aspergillosis of the central nervous system. Journal of the Neurological Sciences 1978, 38: 229–233.

    PubMed  Google Scholar 

  156. Feely, M., Steinberg, M. Aspergillus infection complicating transsphenoidal yttrium-90 pituitary implant: report of two cases. Journal of Neurosurgery 1977, 46: 530–532.

    PubMed  Google Scholar 

  157. Mukoyama, M., Gimple, K., Poser, C. M. Aspergillosis of the central nervous system, Neurology 1969, 19: 967–974.

    PubMed  Google Scholar 

  158. Weinstein, J. M., Sattler, F. A., Towfighi, J., Sassani, J., Page, R. B. Optic neuropathy and paratrigeminal syndrome. Archives of Neurology 1982, 39: 582–585.

    PubMed  Google Scholar 

  159. Ramos-Gabatin, A., Jordan, R. M. Primary pituitary aspergillosis responding to transsphenoidal surgery and combined therapy with amphotericin-B and 5-fluorocytosine. Journal of Neurosurgery 1981, 54: 839–841.

    PubMed  Google Scholar 

  160. Kammer, R. B., Utz, J. P. Aspergillus species endocarditis: the new face of a not so rare disease. American Journal of Medicine 1974, 56: 506–521.

    PubMed  Google Scholar 

  161. Rubinstein, E., Noriega, E. R., Simberkoff, M. S., Holzman, R., Rhal, J. J. Fungal endocarditis: analysis of 24 cases and review of the literature. Medicine 1975, 54: 331–344.

    PubMed  Google Scholar 

  162. Walsh, T. J., Hutchins, G. M., Bukley, B. H., Mendelsohn, G. Fungal infections of the heart: analysis of 51 autopsy cases. American Journal of Cardiology 1980, 45: 357–366.

    PubMed  Google Scholar 

  163. Barst, R. J., Prince, A. S., Neu, H. C. Aspergillus endocarditis in children: case report and review of the literature. Pediatrics 1981, 68: 73–78.

    PubMed  Google Scholar 

  164. Opal, S. M., Reller, L. B., Harrington, G., Cannady, P. Aspergillus clavatus endocarditis involving a normal aortic valve following coronary artery surgery. Reviews of Infectious Disease 1986, 8: 781–785.

    Google Scholar 

  165. Vishniavsky, N., Sagar, K. R., Markowitz, S. M. Aspergillus fumigatus endocarditis on a normal heart valve. Southern Medical Journal 1983, 76: 506–508.

    PubMed  Google Scholar 

  166. Atkinson, J. B., Robinowitz, M., MacAllister, H. A., Forman, M. B., Virmani, R. Cardiac infections in the immunocompromised host. Cardiology Clinics 1984, 2: 671–686.

    PubMed  Google Scholar 

  167. Vo, N. M., Russell, J. C., Becker, D. R. Mycotic emboli of the peripheral vessels: analysis of forty-four cases. Surgery 1981, 90: 541–544.

    PubMed  Google Scholar 

  168. Doscher, W., Krishnasastry, K. V., Deckhoff, S. L. Fungal graft infections: case report and review of the literature. Journal of Vascular Surgery 1987, 6: 398–402.

    PubMed  Google Scholar 

  169. Middleton, J., Chmel, H., Tecson, F., Sarkaria, J., Neville, W. E. Case report. aortotomy site infections: case presentation and review of the literature. American Journal of the Medical Sciences. 1980, 279: 105–109.

    PubMed  Google Scholar 

  170. Tack, K., Rhame, F. S., Brown, B., Thompson, R. C. Aspergillus osteomyelitis. report of four cases and review of the literature. American Journal of Medicine 1982, 73: 295–300.

    PubMed  Google Scholar 

  171. Mawk, J. R., Erickson, D. L., Chou, S. N., Seljeskog, E. L. Aspergillus infections of the lumbar disc spaces. report of three cases. Journal of Neurosurgery 1983, 58: 270–274.

    PubMed  Google Scholar 

  172. Glotzbach, R. E. Aspergillus terreus infection of pseudoaneurysm of aortofemoral vascular graft with contiguous vertebral osteomyelitis. American Society of Clinical Pathologists 1981, 77: 224–227.

    Google Scholar 

  173. Aisner, J., Schimpff, S. C., Wiernik, P. H. Treatment of invasive aspergillosis: relation of early diagnosis and treatment to response. Annals of Internal Medicine 1977, 86: 539–543.

    PubMed  Google Scholar 

  174. Mirsky, H. S., Cuttner, J. Fungal infection in acute leukemia. Cancer 1972, 30: 348–352.

    PubMed  Google Scholar 

  175. Schwartz, R. S., Mackintosh, F. R., Schrier, S. L., Greenberg, P. L. Multivariate analysis of factors associated with invasive fungal disease during remission induction therapy for acute myelogenous leukemia. Invasive Fungal Disease in Leukemia 1984, 53: 411–419.

    Google Scholar 

  176. Burch, P. A., Karp, J. E., Merz, W. G., Kuhlman, J. E., Fishman, E. K. Favorable outcome of invasive aspergillosis in patients with acute leukemia. Journal of Clinical Oncology 1985, 5: 1985–1993.

    Google Scholar 

  177. Peterson, P. K., McGlave, P., Ramsay, N. K. C., Rhame, F., Cohen, E., Perry, G. S., Goldman, A. I., Kersey, J. A prospective study of infectious diseases following bone marrow transplantation: emergence ofAspergillus and cytomegalovirus as the major causes of mortality. Infection Control 1983, 4: 81–89.

    PubMed  Google Scholar 

  178. Pizzo, P. A., Robichaud, K. J., Gill, F. A., Witebsky, F. G. Empiric antibiotic and antifungal therapy for canccr patients with prolonged fever and granulocytopenia. American Journal of Medicine 1982, 72: 101–111.

    PubMed  Google Scholar 

  179. Ippolito, R. J., Seashore, J. H., Touloukian, R. J. Excision of pulmonary and renal aspergillomas. Archives of Surgery 1978, 113: 640–642.

    PubMed  Google Scholar 

  180. Shamberger, R. C., Weinstein, H. J., Grier, H. E., Levey, R. H. The surgical management of fungal pulmonary infections in children with acute myelogenous leukemia. Journal of Pediatric Surgery 1985, 20: 840–844.

    PubMed  Google Scholar 

  181. Karp, J. E., Burch, P. A., Merz, W. G. An approach to intensive antileukemia therapy in patients with previous invasive aspergillosis. American Journal of Medicine 1988, 85: 203–206.

    Google Scholar 

  182. Lopez-Berestein, G., Hopfer, R., Mehta, K., Sullivan, M. P., Keating, M., Rosenblum, M. G., Mehta, R., Luna, M., Hersh, E. M., Reuben, J., Juliana, R. L., Bodey, G. P. Liposomal amphotericin B for the treatment of systemic fungal infections in patients with cancer: a preliminary study. Journal of Infectious Diseases 1985, 151: 704–710.

    PubMed  Google Scholar 

  183. Vadhan-Raj, S., Keating, M., LeMaistre, A., Hittelman, W. N., McCredie, K., Trujillo, J. M., Broxmeyer, H. E., Henney, C., Gutterman, J. U. Effects of recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndromes. New England Journal of Medicine 1987, 317: 1545–1552.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Infectious Diseases (Box 47), Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., 77030, Houston, Texas, USA

    G. P. Bodey & S. Vartivarian

Authors
  1. G. P. Bodey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Vartivarian
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bodey, G.P., Vartivarian, S. Aspergillosis. Eur. J. Clin. Microbiol. Infect. Dis. 8, 413–437 (1989). https://doi.org/10.1007/BF01964057

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01964057

Keywords

Search

Navigation