Clinical spectrum of aspergillosis infections: Observations from a tertiary care setup of Eastern India
Résumé fourni par la source
Background: Aspergillosis represents a diverse group of infections caused by Aspergillus species, ranging from benign allergic reactions to severe invasive disease. While its clinical spectrum is influenced by host immunity and environmental exposure, regional epidemiology remains underexplored, particularly in Eastern India. Aims: This study aimed to characterize the clinical presentation, risk factors, and management outcomes of aspergillosis cases observed over 4 years in two tertiary care centers in Kolkata, India. Methods: A retrospective observational study was conducted, reviewing the records of 35 confirmed aspergillosis cases diagnosed using clinical, radiological, microbiological, histopathological, and immunological criteria. Diagnosis was classified according to international diagnostic definitions, including European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education, international society for human and animal mycology (ISHAM), and ECMM/ISHAM guidelines. Results: Among 35 patients, pulmonary manifestations were predominant ( n = 22), followed by sinus ( n = 10) and extrapulmonary involvement ( n = 3). Allergic fungal rhinosinusitis and allergic bronchopulmonary aspergillosis were common non-invasive manifestations, while invasive pulmonary aspergillosis, cerebral aspergillosis, and Aspergillus osteomyelitis represented severe disease. The most prevalent risk factors included asthma (20%), chronic obstructive pulmonary disease (22.8%), human immunodeficiency viruses/acquired immunodeficiency syndrome (14.3%), and post-COVID-19 status (5.7%). Voriconazole and amphotericin B were the primary antifungal therapies. Clinical outcomes varied by disease spectrum and immune status. Conclusion: Aspergillosis continues to pose significant diagnostic and therapeutic challenges in tertiary care settings. Enhanced surveillance, early diagnosis, and individualized antifungal strategies are vital for reducing morbidity and mortality, especially in immunocompromised populations.