CHRONIC INVASIVE ASPERGILLOSIS IN APPARENTLY IMMUNOCOMPETENT HOSTS

Seventeen cases of invasive aspergillosis occurring since 1987 in appa rently immunologically normal hosts have been reviewed: 9 of invasive sinus aspergillosis, 2 of isolated brain abscesses, 3 of pneumonia (1 in a patient who developed mediastinitis), 2 of lymph node aspergillos is, and 1 of osteomyelitis of the foot, Two of the 9 patients with sin us aspergillosis died; the rest were stable up to March 1993. They res ponded initially to combined surgical and medical therapy. Both patien ts with brain abscesses survived following surgery, but one had neurol ogical sequelae. Both patients with pneumonia were well following ther apy with amphotericin B; one also received itraconazole. The patient w ith mediastinitis died, but this disease was diagnosed late. The patie nts with lymph node involvement were lost to follow-up, as was the pat ient with osteomyelitis. Invasive aspergillosis may be common in Pakis tan. Greater awareness would allow earlier diagnosis and therapy, ther eby improving the outcome.