Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients
| Autor: | Alcyone Artioli Machado, Roberto Martinez, Maria Janete Moya, Gleusa Castro |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Neutropenia Antifungal Agents Itraconazole medicine.medical_treatment Aspergillosis Fatal Outcome medicine Humans Mycosis Voriconazole Leukopenia AIDS-Related Opportunistic Infections business.industry Immunosuppression General Medicine Triazoles medicine.disease Dermatology Surgery Acquired immunodeficiency syndrome Pyrimidines Infectious Diseases Central nervous system Acute Disease Invasive aspergillosis Female Aspergilloma medicine.symptom business medicine.drug |
| Zdroj: | Revista do Instituto de Medicina Tropical de São Paulo; Vol. 51 No. 1 (2009); 49-52 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 51 Núm. 1 (2009); 49-52 Revista do Instituto de Medicina Tropical de São Paulo; v. 51 n. 1 (2009); 49-52 Revista do Instituto de Medicina Tropical de São Paulo Instituto de Medicina Tropical (IMT) instacron:IMT |
| ISSN: | 0036-4665 1678-9946 |
| Popis: | Although uncommon, invasive aspergillosis in the setting of AIDS is important because of its peculiar clinical presentation and high lethality. This report examines two AIDS patients with a history of severe cellular immunosuppression and previous neutropenia, who developed subacute invasive aspergillosis. One female patient developed primary lung aspergilloma, with dissemination to the mediastinum, vertebrae, and spine, which was fatal despite antifungal treatment. The second patient, who had multiple cavitary brain lesions, and eye and lung involvement, recovered following voriconazole and itraconazole, and drugs for increasing neutrophil and CD4+ lymphocyte levels. These cases demonstrate the importance of Aspergillus infections following neutropenia in AIDS patients, and emphasize the need for early and effective antifungal therapy. A aspergilose invasiva em pacientes com aids, embora incomum, é relevante pela apresentação clínica peculiar e alta letalidade. Este relato descreve os casos de dois pacientes com aids com grave imunossupressão celular e neutropenia prévia, os quais tiveram aspergiloma pulmonar primário, com disseminação para mediastino, vértebras e medula espinhal, evoluindo para óbito apesar do tratamento antifúngico. O segundo paciente, que tinha lesões cavitárias múltiplas no cérebro e infecção ocular e pulmonar, recuperou-se após tratamento com voricanazol, itraconazol e com drogas para aumentar o número de neutrófilos e de linfócitos CD4+. Estes casos demonstram o risco de infecção por Aspergillus após episódios de neutropenia em pacientes com aids e alertam para o início precoce de terapia antifúngica eficaz. |
| Databáze: | OpenAIRE |
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