Invasive pulmonary aspergillosis in adult acute leukemia: clinical clues to its diagnosis.
Abstract
Invasive pulmonary aspergillosis, a leading cause of morbidity and mortality in patients with acute leukemia, is difficult to diagnose antemortem because its signs and symptoms are ill-defined. To refine the clinical description of this infection, we reviewed our experience with 15 pathologically documented cases of invasive pulmonary aspergillosis in a population of 60 patients treated for acute leukemia. Findings occurring significantly more often (P less than or equal to .001) among cases than controls included pleuritic chest pain; acute sinus tenderness, and nasal discharge, epistaxis and eschar; rales; development of multilobar infiltrates after the 14th hospital day; and presence of nodular or cavitary infiltrates. In addition, patients with invasive pulmonary aspergillosis had a significantly prolonged duration of granulocytopenia, more febrile days and febrile episodes without a fever diagnosis and more febrile days on antibiotics (P less than or equal to .001 in all). This complex of findings should improve the clinician's ability to diagnose invasive pulmonary aspergillosis in patients with acute leukemia.
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Clinical and radiographic features for IPA diagnosis are subtle and nonspecific and become evident late in the course of the disease, especially in neutropenic patients.
“Clinical and radiographic features for IPA diagnosis are subtle and nonspecific and become evident late in the course of the disease, especially in neutropenic patients (98).”
From Aspergillus fumigatus and Aspergillosis in 2019 (2019) · cites this paper as [98]
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Aspergillus fumigatus and Aspergillosis in 2019
Latgé, J.-P., & Chamilos, G. (2019) · Clinical Microbiology Reviews · doi:10.1128/cmr.00140-18 · Cited by 1,400 · see citing works
Invasive Aspergillosis: Epidemiology, Diagnosis and Management in Immunocompromised Patients
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- Authors
- Gerson, S. L., Talbot, G. H., Lusk, E., Hurwitz, S., Strom, B. L., & Cassileth, P. A.
- Affiliations
- Case Comprehensive Cancer Center (US)
- Case Western Reserve University (US)
- Rutgers Health (US)
- Venue
- Journal of Clinical Oncology
- Published
- 1985-08
- Volume
- 3
- Issue
- 8
- Pages
- 1109-1116
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W1884126821
- Cited by
- 89
- References
- 30
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2015: 2 · 2013: 1
- FWCI
- 4.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (CA-07177)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Keywords
- invasive pulmonary aspergillosis, acute leukemia, diagnosis, febrile neutropenia, granulocytopenia, pleuritic chest pain, eschar, antemortem diagnosis
- MeSH terms
- Acute Disease, Adult, Aged, Agranulocytosis, Aspergillosis, Cough, Female, Fever, Humans, Leukemia, Leukemia, Lymphoid, Lung Diseases, Fungal, Male, Middle Aged, Pain, Paranasal Sinus Diseases, Pleurisy, Radiography, Respiratory Sounds, Leukemia, Myeloid, Acute, Sepsis
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