Incidence and significance of opportunistic fungi in leukemia patients in India

Aspergillus flavus: an emerging non-fumigatus Aspergillus species of significance

Invasive aspergillosis is rare in immunocompetent people but contributes to significant morbidity and mortality in immunosuppressed patients. The majority (approximately 80%) of invasive Aspergillus infections is caused by Aspergillus fumigatus. The second most frequent (approximately 15-20%) pathogenic species is Aspergillus flavus and to a lesser extent, Aspergillus niger and Aspergillus terreus. Aspergillus flavus has emerged as a predominant pathogen in patients with fungal sinusitis and fungal keratitis in several institutions worldwide. To date, there has not been any publication exclusively reviewing the topic of A. flavus in the literature. This article reviews the microbiology, toxigenicity and epidemiology of A. flavus as well as describes the clinical characteristics, diagnosis and management of infections caused by this organism.

Cytotoxic drugs, radiotherapy and oral candidiasis

The increased incidence of oral candidiasis in patients with malignancies stems partly from the systemic disease itself and, partly from the therapeutic measures such as cytotoxic and other immunosuppressive drugs and radiotherapy they receive during management of such malignancies. In this review we discuss the clinical and laboratory findings on the relationship between cytotoxics, radiotherapy and oral candidiasis, possible mechanisms of pathogenicity following such therapy, as well as precautions that could be taken to minimize such recalcitrant yeast infections.

Central venous catheter infection by Aspergillus fumigatus in a patient with B-type non-Hodgkin lymphoma

Invasive Aspergillus infection is still a major problem in immunocompromised patients. A central venous catheter infection by Aspergillus fumigatus, however, has not yet been reported. We describe the case of a 10-year-old female patient with B-type non-Hodgkin lymphoma treated according to the German chemotherapy protocol NHL-BFM 90. Isolation of Aspergillus fumigatus from the blood was the first hint of invasive aspergillosis. A central venous catheter-associated infection was suggested, since Aspergillus was also isolated from the thrombotic tip of the removed catheter. Secondary pulmonary aspergillosis was documented radiologically. The patient was treated successfully by Ampho-thericin B and Itraconazol and explantation of the central venous catheter under conditions of complete hematopoietic regeneration of the bone marrow with omission of the final chemotherapeutic cycle.

Isolation of opportunistic fungi from bronchoalveolar lavage of compromised hosts in Isfahan, Iran

In this study, bronchoalveolar lavage (BAL) specimens from 247 immunocompromised patients were investigated for the incidence of opportunistic fungi. In the direct examination and culture of the specimens, 5 (2.02%) of filamentous fungi and 55 (22.26%) yeasts were isolated and identified as follows: Aspergillus fumigatus (2), A. terreus (1), A. nidulans (1), Mucor sp. (1), Candida albicans (29), C. glabrata (3), C. Parapsilosis (1), Trichosporon beigelii (1), Candida sp. (13) and unknown yeasts (8). In addition, one strain of Nocardia asteroides and two strains of Streptomyces sp. were isolated.