Florica Stăniceanu *, Sabina Zurac **, Adrian Streinu-Cercel ***
* Conf. dr. Florica Stăniceanu, UMF “Carol Davila”, șef Laboratornl de Anatomie Patologică, Spitalul Clinic Colentina, București
** Dr. Sabina Zurac, Laboratorul de Anatomie Patologică, Spitalul Clinic Colentina, București
*** Dr. Adrian Streinu-Cercel, șef lucrări UMF “Carol Davila”, medic primar șef secție Institutul de Boli lnfecțioase “Prof. dr. Matei Balș”, București
Abstract
Aspergillosis is a rare mycotic disease in immunocompetent patients. It is the second in frequency between the invasive mycotic infections in immunodepressed patients, most often affecting the persons with posttransplant immunosuppression and hematological malignancies. In HIV infected persons aspergillosis is a rising in frequency (0.35% in present) due to the highly active antiretroviral therapy (HAART) which increased the longevity of the patients with low levels of CD4+ T cells count (less than 30-50 cells/ mm3). The corticotherapy and neutropenia are risk factors for aspergillosis in HIV infected patients. Aspergillus pneumonia (invasive pulmonary aspergillosis) is the most frequent form of pulmonary disease in HIV infected patients. The prognosis is unfavorable, death occurring in shot time after the diagnosis (median survival 3 months). The identification of the microorganism is very important for establish an efficient therapy but its presence it may signify both the colonization and laboratory contamination. The positive diagnosis of the invasiv pulmonary aspergillosis is established on histopathologic grounds alone, the determination of the .,invasion” consisting in revealing the local tissular destruction. The central nervous system disease has a very unfavorable outcome; it may consist in the occurrence of the cerebral infractions due to the vascular occlusion with Aspergillus or cerebral abscesses most probable subsequent to the direct propagation of the infection from an otic or ophthalmologic aspergillotic focus. The treatment of the aspergillosis in HIV infected patients consists in specific antimycotic medication (amphotericine B, AmBisome (liposomal amphotericine B)), or, if it necessary, surgical treatment.