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Invasive aspergillosis Shuhei YAMAMOTO 1 , Keiji OKINAKA 2,3 , Hanako KURAI 1 1Department of Infectious Diseases Shizuoka Cancer Center 2Department of General Medicine National Cancer Center Hospital East 3Department of Hematopoietic Stem Cell Transplantation National Cancer Center Hospital pp.149-160
Published Date 2019/1/1
DOI https://doi.org/10.11477/mf.3102200608
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Invasive aspergillosis (IA) is a fungal infection which develops in severely immunodeficient patients, and commonly involves the lungs. Biopsy confirmation is necessary to prove the diagnosis, but it is frequently difficult because these procedures have risks for complications and culture and histopathological examination have low sensitivity. To estimate the probability of IA, host factors, clinical signs and biomarkers should all be considered. Among patients at low risk for IA, serum biomarkers may be falsely positive due to a very low prevalence, so initiation of treatment should be decided carefully. In severely immunocompromised patients, especially patients with prolonged neutropenia, empiric antifungal therapy or preemptive therapy is effective to reduce mortality when fever is prolonged despite receiving broad-spectrum antibiotic therapy. Voriconazole is recommended as initial therapy, a lipid formulation of amphotericin B and isavuconazole are alternatives. This review provides an algorithm for the diagnosis and management of IA.


Copyright © 2019, MEDICAL SCIENCES INTERNATIONAL, LTD. All rights reserved.

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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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