Revista do Instituto de Medicina Tropical de São Paulo
On-line version ISSN 1678-9946
MARTINEZ, Roberto; CASTRO, Gleusa de; MACHADO, Alcyone A. and MOYA, Maria Janete. Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients. Rev. Inst. Med. trop. S. Paulo [online]. 2009, vol.51, n.1, pp.49-52. ISSN 1678-9946. http://dx.doi.org/10.1590/S0036-46652009000100009.
Although uncommon, invasive aspergillosis in the setting of AIDS is important because of its peculiar clinical presentation and high lethality. This report examines two AIDS patients with a history of severe cellular immunosuppression and previous neutropenia, who developed subacute invasive aspergillosis. One female patient developed primary lung aspergilloma, with dissemination to the mediastinum, vertebrae, and spine, which was fatal despite antifungal treatment. The second patient, who had multiple cavitary brain lesions, and eye and lung involvement, recovered following voriconazole and itraconazole, and drugs for increasing neutrophil and CD4+ lymphocyte levels. These cases demonstrate the importance of Aspergillus infections following neutropenia in AIDS patients, and emphasize the need for early and effective antifungal therapy.
Keywords : Aspergilloma; Acquired immunodeficiency syndrome; Central nervous system; Invasive aspergillosis; Neutropenia.