PULMONARY ASPERGILLOSIS AND INVASIVE DISEASE IN AIDS - REVIEW OF 342 CASES

Aspergillosis is an infrequent but commonly fatal infection among HIV- infected individuals. We review 342 cases of pulmonary Aspergillus inf ection that have been reported among HIV-infected patients, with a foc us on invasive disease, Invasive pulmonary aspergillosis usually occur s among patients with <50 CD4 cells/mm(3), Major predisposing conditio ns include neutropenia and steroid treatment. Fever, cough, and dyspne a are each present in >60% of the cases. BAL is often suggestive, but biopsy specimens are necessary for definite diagnosis. Amphotericin B is the mainstay of treatment and mortality is >80%. Avoiding neutropen ia and judicious use of steroids may be helpful in prevention. Aggress ive diagnostic approach, early initiation of treatment, adequate dosin g of antifungals, and close follow-up may improve the currently dismal prognosis.