The DOI matches its Crossref record, with a small difference in title or year; 276 of the 276 references it cites were found in a registry or an index.
Invasive Aspergillosis: Epidemiology, Diagnosis and Management in Immunocompromised Patients
Abstract
Morbidity and mortality caused by invasive Aspergillus infections are increasing. This is because of the higher number of patients with malignancies treated with intensive immunosuppressive therapy regimens as well as their improved survival from formerly fatal bacterial infections, and the rising number of patients undergoing allogeneic haematopoietic stem cell or organ transplantation. Early initiation of effective systemic antifungal treatment is essential for a successful clinical outcome in these patients; however, clinical clues for diagnosis are sparse and early microbiological proof of invasive aspergillosis (IA) is rare. Clinical diagnosis is based on pulmonary CT scan findings and non-culture based diagnostic techniques such as galactomannan or DNA detection in blood or bronchoalveolar lavage samples. Most promising outcomes can be expected in patients at high risk for aspergillosis in whom antifungal treatment has been started pre-emptively, backed up by laboratory and imaging findings. The gold standard of systemic antifungal treatment is voriconazole, which has been proven to be significantly superior to conventional amphotericin B and has led to a profound improvement of survival rates in patients with cerebral aspergillosis. Liposomal amphotericin B at standard dosages appears to be a suitable alternative for primary treatment, while caspofungin, amphotericin B lipid complex or posaconazole have shown partial or complete response in patients who had been refractory to or intolerant of primary antifungal therapy. Combination therapy with two antifungal compounds may be a promising future strategy for first-line treatment. Lung resection helps to prevent fatal haemorrhage in single patients with pulmonary lesions located in close proximity to larger blood vessels, but is primarily considered for reducing the risk of relapse during subsequent periods of severe immunosuppression. Strict reverse isolation appears to reduce the incidence of aspergillosis in allogeneic stem cell transplant recipients and patients with acute myeloid leukaemia undergoing aggressive anticancer therapy. Well designed, prospective randomised studies on infection control measures effective to prevent aspergillosis are lacking. Prophylactic systemic antifungal treatment with posaconazole significantly improves survival and reduces IA in acute myeloid leukaemia patients and reduces aspergillosis incidence rates in patients with intermediate-to-severe graft-versus-host reaction emerging after allogeneic haematopoietic stem cell transplantation. Voriconazole prophylaxis may be suitable for prevention of IA as well; however, the results of large clinical trials are still awaited.
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“With increasingly immunocompromised patient populations, other fungal species such as Aspergillus species, Pneumocystis jiroveci, Cryptococcus, Zygomycetes, Fusarium species, and Scedosporium species have emerged.[4][5][6][7][8][9]”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [4]
Citations
Cites
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Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia
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Howard, S. J., Cerar, D., Anderson, M. J., Albarrag, A., Fisher, M. C., Pasqualotto, A. C., Laverdiere, M., Arendrup, M. C., Perlin, D. S., & Denning, D. W. (2009) · Emerging Infectious Diseases · doi:10.3201/eid1507.090043 · Cited by 750
Factors associated with mortality in transplant patients with invasive aspergillosis
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Breakthrough invasive fungal infections: Who is at risk?
Jenks, J. D., Cornely, O. A., Chen, S. C. ‐., Thompson, G. R., & Hoenigl, M. (2020) · Mycoses · doi:10.1111/myc.13148 · Cited by 191
Self-citationTriazole Resistance in Aspergillus spp.: A Worldwide Problem?
Rivero-Menendez, O., Alastruey-Izquierdo, A., Mellado, E., & Cuenca-Estrella, M. (2016) · Journal of Fungi · doi:10.3390/jof2030021 · Cited by 142
He, Q., Li, H., Rui, Y., Liu, L., He, B., Shi, Y., & Su, X. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/cix749 · Cited by 78
Metadata
- Authors
- Maschmeyer, G., Haas, A., & Cornely, O. A.
- Affiliations
- Klinikum Ernst von Bergmann (DE)
- University Hospital Cologne (DE)
- Corresponding author
- Maschmeyer, Georg
- Venue
- Drugs
- Published
- 2007
- Volume
- 67
- Issue
- 11
- Pages
- 1567-1601
- ISSN
- 0012-6667 (ISSN-L)
- OpenAlex
- W2088013043
- Cited by
- 366
- References
- 276
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 13 · 2023: 9 · 2022: 8 · 2021: 16 · 2020: 15 · 2019: 14 · 2018: 13 · 2017: 12 · 2016: 21 · 2015: 23 · 2014: 27 · 2013: 24 · 2012: 30
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drugs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Keywords
- invasive aspergillosis, Aspergillus, voriconazole, amphotericin B, caspofungin, posaconazole, antifungal prophylaxis, immunosuppression, hematopoietic stem cell transplantation, acute myeloid leukemia, galactomannan, cerebral aspergillosis, lung resection, infection control, graft-versus-host disease
- MeSH terms
- Antifungal Agents, Antineoplastic Agents, Aspergillosis, Drug Therapy, Combination, Humans, Neoplasms, Quarantine, Risk Factors, Transplantation Immunology, Organ Transplantation, Immunocompromised Host, Hematopoietic Stem Cell Transplantation
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