{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:53:33Z","timestamp":1765727613799,"version":"3.48.0"},"reference-count":19,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1994,9]]},"abstract":"<jats:p>AIMS--To review the clinical, radiographic, and therapeutic features of 11 cases of respiratory Aspergillus infection in patients with AIDS. METHODS--All induced sputum and bronchoalveolar lavage samples obtained from HIV seropositive patients between January 1985 and March 1993 were analysed for Aspergillus species. Additionally, where appropriate, bronchial or renal biopsy specimens, or both, were taken before treatment had started. RESULTS--In 11 patients Aspergillus fumigatus was identified in alveolar samples obtained by sputum induction. This was confirmed by bronchoalveolar lavage in eight. Three patients had Aspergillus plaques in the trachea and bronchus, while a fourth patient had an aspergilloma. Risk factors for Aspergillus infection were present in all patients, including corticosteroid treatment in three cases and neutropenia in four, three of whom had received chemotherapy for Kaposi's sarcoma. Four patients had concomitant cytomegalovirus infection. Ten patients had a CD4 count of less than 50 cells\/mm3 while one patient had a disseminated T cell lymphoma with a CD4 count of 242 cells\/mm3. Of the three patients with samples obtained by sputum induction who did not undergo bronchoscopy, two had a normal chest x ray picture and the third had a right lobar pneumonia complicating an aggressive lymphoma. All three were treated with itraconazole 200 mg twice a day without further investigation. Survival from the time of diagnosis of Aspergillus infection was short: seven patients died within six weeks, although only one death was directly attributed to pulmonary aspergillosis. At six monthly follow up, one patient, who initially had a positive Aspergillus culture from bronchial washings and a normal chest radiograph, developed a renal aspergilloma despite the disappearance of Aspergillus sp from the sputum. CONCLUSION--Pulmonary aspergillosis is an important clinical problem in patients with AIDS with a CD4 count of less than 50 cells\/mm. Furthermore, patients with Aspergillus sp in sputum induction or bronchial washings may develop disseminated disease despite adequate treatment of the primary infection.<\/jats:p>","DOI":"10.1136\/jcp.47.9.805","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"805-809","source":"Crossref","is-referenced-by-count":25,"title":["Management of pulmonary aspergillosis in AIDS: an emerging clinical problem."],"prefix":"10.1136","volume":"47","author":[{"given":"J J","family":"Keating","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Petrou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J D","family":"Cartledge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Woodrow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D A","family":"Hawkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B G","family":"Gazzard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1994,9,1]]},"reference":[{"article-title":"Abstract","year":"1994","key":"ref_1","unstructured":"February 1994 Abstract"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0002-9343(93)90258-Q","article-title":"Invasive aspergillosis in patients with Acquired Immunodeficiency Syndrome. Report of 33 cases","volume":"95","author":"Lortholary 0, Meyohas MC, DuPont B","year":"1993","unstructured":"Lortholary 0, Meyohas MC, DuPont B, et al. Invasive aspergillosis in patients with Acquired Immunodeficiency Syndrome. Report of 33 cases. Am Med 1993;95:177-87.","journal-title":"Am Med"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1056\/NEJM199103073241003","article-title":"Pulmonary aspergil}osis in the acquired immunodeficiency syndrome","volume":"324","author":"Denning, D.W.; Follansbee, S.E.; Scolaro, M.","year":"1991","unstructured":"Denning DW, Follansbee SE, Scolaro M, et al. Pulmonary aspergil}osis in the acquired immunodeficiency syndrome. NEnglJMed 1991;324:654-62.","journal-title":"NEnglJMed"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1093\/clinids\/12.6.1147","article-title":"Antifungal and surgical treatment of invasive aspergillosis: review of 2,121 published cases","volume":"12","author":"Denning, D.W.; Stevens, D.A.","year":"1990","unstructured":"Denning DW, Stevens DA. Antifungal and surgical treatment of invasive aspergillosis: review of 2,121 published cases. Rev Infect Dis 1990;12:1147-201.","journal-title":"Rev Infect Dis"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1093\/clinids\/14.1.66","article-title":"Invasive aspergillosis in patients with AIDS","volume":"14","author":"Minamoto, G.Y.; Barlam, T.F.; Vander Els, N.J.","year":"1992","unstructured":"Minamoto GY, Barlam TF, Vander Els NJ. Invasive aspergillosis in patients with AIDS. Clin Infect Dis 1992; 14:66-74.","journal-title":"Clin Infect Dis"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1093\/clinids\/14.1.141","article-title":"Aspergillus species colonization and invasive disease in patients with AIDS","volume":"14","author":"Pursell, K.; Teizak, E.E.; Armstrong, D.","year":"1992","unstructured":"Pursell K, Teizak EE, Armstrong D. Aspergillus species colonization and invasive disease in patients with AIDS. Clin Infect Dis 1992;14:141-8.","journal-title":"Clin Infect Dis"},{"key":"ref_7","first-page":"118","article-title":"Clinical manifestations and management of aspergillosis in the compromised patient","volume-title":"infection in the compromised patient","author":"Cohen, J.","year":"1991","unstructured":"Cohen J. Clinical manifestations and management of aspergillosis in the compromised patient. In: Warnock DW, Richardson MD, eds. Fungal infection in the compromised patient. New York: John Wiley and Sons, 1991: 118-52."},{"key":"ref_8","first-page":"653","article-title":"Invasive aspergillosis: an unusual manifestation of AIDS","volume":"12","author":"Asnis, D.S.; Chitkara, R.K.; Jacobson, M.; Goldstein, J.A.","year":"1988","unstructured":"Asnis DS, Chitkara RK, Jacobson M, Goldstein JA. Invasive aspergillosis: an unusual manifestation of AIDS. NYStateJMed 1988;12:653-5.","journal-title":"NYStateJMed"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1097\/00007611-199107000-00003","article-title":"Invasive aspergillosis in AIDS","volume":"84","author":"Singh, N.; Yu, V.L.; Rihs, J.D.","year":"1991","unstructured":"Singh N, Yu VL, Rihs JD. Invasive aspergillosis in AIDS. South Med 1991;84:822-7.","journal-title":"South Med"},{"key":"ref_10","first-page":"727","article-title":"Acquired immunodeficiency syndrome: clinicopathologic study of 56 autopsies","volume":"109","author":"Niedt, G.W.; Schinella, R.A.","year":"1985","unstructured":"Niedt GW, Schinella RA. Acquired immunodeficiency syndrome: clinicopathologic study of 56 autopsies. Arch Pathol Lab Med 1985;109:727-34.","journal-title":"Arch Pathol Lab Med"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/0002-9149(85)90679-4","article-title":"Cardiac aspergillosis in acquired immune deficiency syndrome","volume":"55","author":"Henochowicz, S.; Musafa, M.; Lawrinson, W.E.; Pistole, M.; Lindsay, J.","year":"1985","unstructured":"Henochowicz S, Musafa M, Lawrinson WE, Pistole M, Lindsay J. Cardiac aspergillosis in acquired immune deficiency syndrome. Am Cardiol 1985;55: 1239-40.","journal-title":"Am Cardiol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1001\/archneur.1990.00530020087020","article-title":"Aspergillus infection in the central nervous system in patients with acquired immunodeficiency syndrome","volume":"47","author":"Woods, G.L.; Goldsmith, J.C.","year":"1990","unstructured":"Woods GL, Goldsmith JC. Aspergillus infection in the central nervous system in patients with acquired immunodeficiency syndrome. Arch Neurol 1990;47: 181-4.","journal-title":"Arch Neurol"},{"key":"ref_13","first-page":"1200","article-title":"A peripancreatic abscess containing Aspergillus in a patient with the acquired immune deficiency syndrome","volume":"85","author":"Bhatt, B.; Cappell, M.S.","year":"1990","unstructured":"Bhatt B, Cappell MS. A peripancreatic abscess containing Aspergillus in a patient with the acquired immune deficiency syndrome. AmJ Gastroenterol 1990;85:1200.","journal-title":"AmJ Gastroenterol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1002\/1097-0142(19840201)53:3<411::AID-CNCR2820530308>3.0.CO;2-E","article-title":"Multivariate analysis of factors associated with invasive fungal disease during remission induction therapy for acute myelogenous leukaemia","volume":"53","author":"Schwartz, R.S.; Mackintosh, F.R.; Schrier, S.L.; Greenberg, P.L.","year":"1984","unstructured":"Schwartz RS, Mackintosh FR, Schrier SL, Greenberg PL. Multivariate analysis of factors associated with invasive fungal disease during remission induction therapy for acute myelogenous leukaemia. Cancer 1984;53:411-9.","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1093\/infdis\/149.5.828-a","article-title":"Acquired immunodeficiency syndrome: is disseminated aspergillosis predictive of underlying cellular immunodeficiency?","volume":"149","author":"Schaffner, A.","year":"1984","unstructured":"Schaffner A. Acquired immunodeficiency syndrome: is disseminated aspergillosis predictive of underlying cellular immunodeficiency? Infect Dis 1984;149:822-9.","journal-title":"Infect Dis"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1378\/chest.94.2.432","article-title":"Fatal aspergillosis associated with smoking contaminated marijuana in a marrow transplant recipient","volume":"94","author":"Hamadeh, R.; Ardehali, A.; Locksley, R.M.; York, M.K.","year":"1988","unstructured":"Hamadeh R, Ardehali A, Locksley RM, York MK. Fatal aspergillosis associated with smoking contaminated marijuana in a marrow transplant recipient. Chest 1988;94:432-3.","journal-title":"Chest"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1056\/NEJM197804272981705","article-title":"Increased puimonary superinfections in cardiac-transplant patients undergoing primary cytomegalovirus infection","volume":"298","author":"Rand, K.H.; Pollard, R.B.; Merigan, T.C.","year":"1978","unstructured":"Rand KH, Pollard RB, Merigan TC. Increased puimonary superinfections in cardiac-transplant patients undergoing primary cytomegalovirus infection. N Engl Med 1978;298:951-3.","journal-title":"N Engl Med"},{"key":"ref_18","first-page":"791","article-title":"Treatment of invasive aspergillosis with itraconazole","volume":"86","author":"Denning, D.W.; Tucker, R.; Hanson, L.H.; Stevens, D.A.","year":"1989","unstructured":"Denning DW, Tucker R, Hanson LH, Stevens DA. Treatment of invasive aspergillosis with itraconazole. Am J7Med 1989;86:791-800.","journal-title":"Am J7Med"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/0190-9622(90)70263-H","article-title":"Itraconazole therapy in aspergillosis: study in 49 patients","volume":"23","author":"Dupont, B.","year":"1990","unstructured":"Dupont B. Itraconazole therapy in aspergillosis: study in 49 patients. JAm Acad Dermatol 1990;23:607-14.","journal-title":"JAm Acad Dermatol"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.47.9.805","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:49:37Z","timestamp":1765727377000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.47.9.805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,9]]},"references-count":19,"journal-issue":{"issue":"9","published-online":{"date-parts":[[1994,9,1]]},"published-print":{"date-parts":[[1994,9]]}},"alternative-id":["10.1136\/jcp.47.9.805"],"URL":"https:\/\/doi.org\/10.1136\/jcp.47.9.805","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[1994,9]]}}}