INVASIVE PULMONAR ASPERGILLOSIS - REPORT OF 16 CASES

Invasive pulmonar aspergillosis (IPA) is a severe infection which is u sually diagnosed at postmortem examination. This infection occurs main ly in immunosuppresed patients, although it has also been reported in immunocompetent patients. Clinical records from patients diagnosed wit h IPA in our institution from 1983 to 1992 were retrospectively studie d to analyse clinical and therapeutical characteristics of IPA. Sixtee n episodes of IPA were recorded, all of them but one from necropsic sp ecimens. A total of 18.7% of patients were immunocompetent, one patien t had the acquired immunodeficiency syndrome (AIDS), and the remaining patients had a classical immunosuppression. Fever and dyspnea were no ted in all patients; hemoptysis was recorded in 12.5% of patients. The predominant radiological pattern was a bilateral alveolar infiltrate (75%). Diagnosis was made at postmortem examination in 15 cases (93.7% ), and a clinical premortem suspicion was obtained only in 25% of pati ents. IPA can occur in immunocompetent patients more frequently than c onsidered until now. The suspicion index for IPA is low, even in immun osuppressed patients.