Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- 170 Candidiasis
- 171 Aspergillosis
- 172 Zygomycosis (Mucormycosis)
- 173 Sporotrichosis
- 174 Cryptococcus
- 175 Histoplasmosis
- 176 Blastomycosis
- 177 Coccidioidomycosis
- 178 Pneumocystis Pneumonia
- 179 Miscellaneous Fungi and Algae
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
171 - Aspergillosis
from Part XXII - Specific Organisms – Fungi
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- 170 Candidiasis
- 171 Aspergillosis
- 172 Zygomycosis (Mucormycosis)
- 173 Sporotrichosis
- 174 Cryptococcus
- 175 Histoplasmosis
- 176 Blastomycosis
- 177 Coccidioidomycosis
- 178 Pneumocystis Pneumonia
- 179 Miscellaneous Fungi and Algae
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Aspergillus is readily isolated from samples of soil, decaying vegetation, water, and air worldwide. Aspergillus fumigatus, followed by Aspergillus flavus, Aspergillus niger, and Aspergillus terreus, are the most common species that cause human disease. Aspergillosis follows exposure of a susceptible host to the ubiquitous conidia (spores). Germinating conidia form hyphae, the invasive form of the fungus. Aspergillus hyphae average 2 to 4 μ in diameter and are septate, with dichotomous (Y-shaped) branching (Figure 171.1). The spectrum of diseases caused by the aspergilli is wide and profoundly influenced by the underlying immune status of the host.
CLINICAL MANIFESTATIONS AND DIAGNOSIS OF INVASIVE ASPERGILLOSIS
Although inhalation of conidia is common, invasive disease is relatively rare. The vast majority of affected patients are severely immunosuppressed. Major risk factors include profound, prolonged neutropenia due to cytotoxic chemotherapy and macrophage dysfunction due to high doses of corticosteroids. In patients who have undergone hematopoietic stem cell transplantation, additional risk factors are graft-versus-host disease and cytomegalovirus infection. Invasive aspergillosis also is particularly common in individuals with chronic granulomatous disease (CGD), a rare genetic disorder characterized by a defective phagocyte respiratory burst. Finally, recent studies have suggested that critically ill patients are at risk for invasive aspergillosis, even without aforementioned risk factors.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 1187 - 1194Publisher: Cambridge University PressPrint publication year: 2008