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- W1901296023 abstract "The recent article by Paterson [1Paterson DL New clinical presentations of invasive aspergillosis in non-conventional hosts.Clin Microbiol Infect. 2004; 10: 24-30Crossref PubMed Scopus (37) Google Scholar] provided an update on the changing nature of infection with Aspergillus spp., and highlighted the appearance of this disease in non-conventional hosts. Our own experience with aspergillosis in a veteran population hospitalised at the Salem Veterans Affairs Medical Center also supports a shift in the nature of the affected patients. Following review of all inpatients between 1989 and 2003, 17 patients were identified with Aspergillus infection. The mean age of these patients was 59.8 years, all were male, 15 were Caucasian and two were African-American. Thirteen (76%) were smokers. Concurrent medical illness included chronic obstructive pulmonary disease in seven patients, and pre-existing cavitary lung lesions in four. Two patients had a history of treated tuberculosis. Only four patients were immunocompromised, three with AIDS and one with chronic lymphocytic leukaemia. Presenting symptoms were dyspnoea or cough in nine patients, haemoptysis in three, stroke in one, and sinusitis in one. Eleven immunocompetent patients had pulmonary involvement (five patients with Aspergillus pneumonia, with one complicated by empyema, five cavitary lung lesions and one isolated Aspergillus empyema). One immunocompetent patient had invasive maxillary sinusitis, and one had septic arthritis. One immunocompromised patient had disseminated aspergillosis and presented with a posterior circulation stroke, two had pulmonary involvement, and one had perioral cutaneous spread. Patients were treated with amphotericin B or triazole antifungal agents based on the severity of the disease. The deaths of five patients were related to Aspergillus infection, but three of these were identified only at autopsy. Of the latter three cases, one patient had AIDS, with a stroke resulting from vascular invasion, while two deaths were of immunocompetent patients with pulmonary aspergillosis. Aspergillosis as a clinical entity is difficult to diagnose, and is diagnosed occasionally only at autopsy. We concur with Dr Paterson's assessment that a higher index of suspicion is needed to improve the outcomes for patients with invasive Aspergillus infection, not only in immunocompromised patients, but also in immunocompetent hosts." @default.
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- W1901296023 date "2004-07-01" @default.
- W1901296023 modified "2023-09-23" @default.
- W1901296023 title "Aspergillus infection in a hospitalised veteran population" @default.
- W1901296023 cites W1885631213 @default.
- W1901296023 doi "https://doi.org/10.1111/j.1469-0691.2004.00912.x" @default.
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