Clinical characteristics of aspergillus infection and colonization in 35 patients with acquired immune deficiency syndrome
10.3760/cma.j.issn.1000-6680.2018.08.006
- VernacularTitle:35例艾滋病患者曲霉菌感染与定植临床特征分析
- Author:
Zhenyan WANG
1
;
Yinzhong SHEN
;
Li LIU
;
Renfang ZHANG
;
Tangkai QI
;
Wei SONG
;
Yang TANG
;
Jun CHEN
;
Jiangrong WANG
;
Hongzhou LU
Author Information
1. 201508,上海市(复旦大学附属)公共卫生临床中心感染与免疫科
- Keywords:
Acquired immunodeficiency syndrome;
Aspergillus;
Pulmonary aspergillosis
- From:
Chinese Journal of Infectious Diseases
2018;36(8):485-489
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics of aspergillus infection and colonization in acquired immune deficiency syndrome (AIDS) patients .Methods A retrospective study was performed in 35 AIDS patients who were admitted to Shanghai Public Health Clinical Center between January 2011 and December 2016 with etiology or histopathological evidence of aspergillus infection and colonization . Results The median age of these patients was 47 years old and 33 patients (94 .3％ ) were male .The median CD4+ T cell count was 24 cells/μL ,and 29 (82 .9％ ) patients had a CD4+ T cell count < 100 cells/μL .Twenty-three patients (65 .7％ ) were diagnosed with aspergillosis ,including 20 pulmonary aspergillosis (brain was involved in 1 case) ,1 renal aspergillosis and 2 intestinal aspergillosis .Twelve patients (34 .3％ ) were diagnosed with respiratory tract colonization . The most frequently cultured aspergillus species was Aspergillus f umigatus (45 .2％ ) .Other infections and underlying risk factors coexisted in 32 patients (91 .4％ ) ,of which pneumocystis jirovecii pneumoni (34 .3％ ) and pulmonary tuberculosis (25 .7％ ) were the most common . The patients with aspergillus colonization showed a significantly higher prevalence of pulmonary tuberculosis (PTB) than those with aspergillosis (58 .3％ vs 10％ ,P=0 .006) .The most common symptoms in pulmonary aspergillosis were cough (100 .0％ ) ,fever(90 .0％ ) ,expectoration (60 .0％ ) ,dyspnea (55 .0％ ) and hemoptysis (10 .0％ ) .The death rate within one year after diagnosis in pulmonary aspergilosis group was significantly higher than colonization group (55％ vs 0％ ,P=0 .000) .Conclusions Pulmonary aspergilosis is the most common disease caused by aspergillus in AIDS patients ,and frequently occurs in those with CD4+ T cell counts <100 cells/μL ,with a high mortality rate .Coinfections with other opportunistic pathogens and combination with other risk factors are common .Clinicians should be alert that aspergillus may colonize in AIDS patients with PTB w hen sputum aspergillus is positive .
