Invasive pulmonale Aspergillose

Abstract

Invasive pulmonary aspergillosis is a life-threatening disease occurring in patients with severe immunosuppression. It is classically associated with severe neutropenia following hematopoietic stem cell transplantation, but other risk factors include COPD, corticosteroid therapy, solid organ transplant, liver failure and preceding severe influenza infection. Due to the high mortality of the disease, rapid diagnosis and treatment are crucial. Diagnosis is based on CT scan and bronchoscopy including microscopy, culture and galactomannan detection in BAL. Histopathology remains the gold standard diagnosis but is not feasible in many cases. First line treatment is voriconazole, new recommendations also support the triazole isavuconazole.

Die invasive pulmonale Aspergillose ist eine lebensbedrohliche Erkrankung, die bei Patienten mit schwerer Immunsuppression auftritt. Klassischerweise sind Patienten mit schwerer Neutropenie nach Stammzelltransplantation betroffen, aber auch andere Risikofaktoren spielen eine Rolle. Aufgrund der hohen Mortalität der Erkrankung sind eine zügige und sichere Diagnosestellung und folgende Therapieeinleitung entscheidend.

Schlüsselwörter

Aspergillose - Immunsuppression - Aspergillus spp. - COPD - Steroidtherapie - Neutropenie - Intensivstation - Isavuconazol

Key words

aspergillosis - immunosuppression - Aspergillus - chronic obstructive pulmonary disease - steroid therapy - neutropenia - intensive care - isavuconazole

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