Invasive pulmonary aspergillosis in AIDS patients.

Frequency, clinical features, and prognosis of pulmonary aspergillosis were studied in AIDS patients. This retrospective study was carried out between 1987 and 1995, among 420 AIDS patients. Aspergillus sp. was isolated in 12 patients. Invasive aspergillosis is an uncommon infectious complication in patients with AIDS. Aspergillus sp. was isolated in only 12 of the 420 patients with AIDS followed between 1987 and 1995 in our department invasive aspergillosis was confirmed by histology in eight patients. invasive aspergillosis was considered as probable with the halo sign in chest CT scan and two positive bronchoalveolar lavage fluid cultures for Aspergillus sp. in one patient In the three other cases, Aspergillus sp. isolation was considered as colonization. Cough and fever were the most common symptoms. Radiological patterns included upper-lobe cavitary disease, nodules, pleura-based lesions, and diffuse infiltrates (mainly of the lower lobe). Typical CT scan findings were. pleura-based lesions, triangular shaped lesions contiguous to the pleura of the major fissure, and the halo sign. A new and sensitive Elisa test could be used to detect significant amounts of Aspergillus sp. antigens (galactomannan) in body fluids and may provide a non-invasive diagnosis test Death was the usual outcome, despite treatment with amphotericin B and/or itraconazole. New approaches must be investigated (C) 1999 Elsevier, Paris.