A. Horib, a, f1, M. Kamia, b, Y. Kishia, U. Machidac, T. Matsumurad and T. Kashimae
a Department of Hematology, Toranomon Hospital, Tokyo, Japan
c Department of Hematology and Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
d Department of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
b Hematopoietic Stem Cell Transplant Unit, National Cancer Center Hospital, Tokyo, Japan
e Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
Received 18 September 2001; accepted 18 December 2001. ; Available online 25 March 2002.
Abstract
Disseminated aspergillus infection has a poor prognosis, but few reports have been published on extra-pulmonary involvement in aspergillosis. We reviewed 107 autopsy records of patients with invasive aspergillosis. Fifty-five patients had extra-pulmonary aspergillosis. Organs involved included heart, kidney, central nervous system, gastrointestinal tract, spleen, liver, thyroid gland and pancreas. Extra-pulmonary aspergillosis produces different manifestations according to involved organs. Risk factors associated with dissemination included cytotoxic chemotherapy within a month of death (P=0.0087). Lack of response to empiric or preemptive treatment of amphotericin B predicted IA dissemination (P=0.0328). To improve prognosis of IA, it is important to recognize clinical features of extra-pulmonary aspergillosis and to institute the aggressive anti-fungal treatment.
Author Keywords:
Invasive aspergillosis, haematological malignancy,
extra-pulmonary aspergillosis, retrospective study, autopsy
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