Aspergillosis in immunocompromised patients with haematological malignancies

Abstract

Aspergillosis, which is saprophytic in nature, is known to cause massive destruction of paranasal sinuses in immunocompromised hosts, but in immunocompetent individuals invasive aspergillosis is rare. Diagnosis is posed from history, physical examination including anterior and posterior rhinoscopy, endoscopy of the nose and paranasal sinuses, radiological findings (CT and/or MRI), fungus cultures and histopathological examination. Non-specific presenting symptoms provide time for infection to extent from sinuses to vital surroundings such as bony, vascular and central nervous system structures, thereby increasing morbidity and mortality. Mass lesions involving the sinuses are initially misdiagnosed as tumors, inflammatory pseudotumors or pituitary adenomas. Therefore, diagnosis should be always confirmed by histopathology. Aspergillus sinusitis is a potentially fatal complication of immunosupression or of chemotherapy-induced leucopenia. Concerning patients with hematologic malignancies, it seems that its incidence is progressively increased. A combination of early diagnosis and application of specific antifungals provides the perfect management and prognosis in the corresponding patients. In the current special review, we present new data regarding the infection in patients with hematologic malignancies. © 2018 Zerbinis Publications. All Rights Reserved.