INVASIVE MOLD INFECTIONS IN THE UNIVERSIT Y CLINICS OF LEIPZIG DURINGTHE PERIOD FROM 1992 TO 1994

Invasive mould infection, e. g. aspergillosis in the first place, is a common infection in immunocompromised patients. The diagnosis of inva sive mould infection is difficult in the absence of confirmation by ti ssue biopsy and histological studies. Therefore, prevalence of invasiv e mould infections at the School of Medicine of the Leipzig University between 1992 and 1994 was investiated. The diagnosis of invasive moul d infection was suspected on clinical, mycological, and radiological f indings. The definitive diagnosis was obtained by identification of ch aracteristic mould hyphae on stained smears, and/or positive culture, and/or the detection of Aspergillus antigen (Pastorex) in serum, bronc hial secretion, or bronchoalveolar fluid, and confirmed by histopathol ogy. In altogether 21 patients the definitive diagnosis invasive mould infection was recorded, among them 20 invasive aspergilloses. Underly ing diseases were leukaemia (n=11), aplastic anaemia (n=2), non-Hodgki n-lymphoma (n=1), systemic lupus erythematosus (n=1), kidney transplan tation (n=1), peritonitis after Billroth II anastomosis (n=1), Polymya lgia rheumatica (n=1), AIDS plus Burkitt lymphoma (n=1), glioblastoma (n=1), and subarachnoid haemorrhage (n=1). As causative fungi were iso lated: Aspergillus fumigatus (n=13), Aspergillus terreus (n=1), Asperg illus flavus as rare simultaneous infection with the basidiomycete Cop rinus spec. in a leukaemic patient (n=1), and the dematiaceous fungus Scedosporium prolificans in an AIDS patient with Burkitt lymphoma (n=1 ). In four patients the invasive mould infection as confirmed histopat hologically without isolation and differentiation of the causative age nt. Nineteen of the 21 patients with invasive mould infection died cor responding to a mortality rate of 90 %.