CASE REPORT
Invasive pulmonary aspergillosis in a HIV-infected patient with metastatic, non-small cell lung cancer
 
More details
Hide details
 
Submission date: 2016-12-18
 
 
Final revision date: 2017-05-31
 
 
Acceptance date: 2017-07-29
 
 
Publication date: 2017-10-07
 
 
HIV & AIDS Review 2017;16(3):195-197
 
KEYWORDS
TOPICS
ABSTRACT
Aspergillus species remains an important cause of morbidity and mortality in immunosuppressed patients. The following case report presents a 56-year-old HIV-infected patient on successful combined antiretroviral therapy (cART), who was diagnosed with non-small cell lung cancer in November 2015 and invasive aspergillosis in January 2016. At that time, we noticed a sudden decrease of his CD4+ count from 758 cells/μl in October 2015 to 48 cells/μl in January 2016. It was probably not a result of HIV infection, because viral load had been undetectable, and the CD4+ count had remained > 500 cells/μl for many years. It is more likely that the patient’s severe lymphopenia was caused by metastatic cancer and the treatment (radiotherapy) that had been applied. There is data showing that a significant decrease of the CD4+ count is a frequent side effect in patients following treatment with radiation and chemotherapy for newly diagnosed solid tumors, regardless of histopathology and the type of chemotherapy. Both advanced AIDS and immune deficiencies connected with solid organ tumors are risk factors for invasive pulmonary aspergillosis and as the case described illustrates, these two medical conditions are often connected with severe lym-phopenia. The question that arises is whether severe lymphopenia constitutes an independent risk factor for invasive pulmonary aspergillosis.
 
REFERENCES (10)
1.
Kousha M, Tadi R, Soubani AO. Pulmonary aspergillosis: a clinical review. Eur Respir Rev 2011; 20: 121, 156-174.
 
2.
Petterson TF, Kirkpatrick WR, White M, et al. Invasive Aspergillosis. Disease Spectrum, Treatment Practices and Outcomes. Medicine 2000; 79: 250-260.
 
3.
Lortholary O, Meyohas MC, Dupont B, et al. Invasive aspergillosis in patients with acquired immunodeficiency syndrome: report of 33 cases. French Cooperative Study Group on Aspergillosis in AIDS. Am J Med 1993; 95: 177-187.
 
4.
Soubani AO, Khanchandani G, Ahmed HP. Clinical significance of lower respiratory tract aspergillus culture in elderly hospitalized patients. Eur J Clin Microbiol Infect Dis 2004; 23: 491-494.
 
5.
Yu VL, Muder RR, Poorsattar A. Significance of isolation of Aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis. Results from a three-year prospective study. Am J Med 1986; 81: 249-254.
 
6.
Kuhlman JE, Fishman EK, Siegelman SS. Invasive pulmonary aspergillosis in acute leukemia: characteristic findings on CT, the CT halo sign, and the role of CT in early diagnosis. Radiology 1985; 157: 611-614.
 
7.
Denning DW, Follansbee SE, Scolaro M, et al. Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N Engl J Med 1991; 324: 654-662.
 
8.
Mylonakis E, Barlam TF, Flanigan T, et al. Pulmonary aspergillosis and invasive disease in AIDS: review of 342 cases. Chest 1998; 114: 251-262.
 
9.
Schacker TW, Nguyen PL, Martinez E, et al. Persistent abnormalities in lymphoid tissues of human immunodeficiency virus-infected patients successfully treated with highly active antiretroviral therapy. J Infect Dis 2002; 186: 1092-1097.
 
10.
Grossman SA, Ellsworth S, Campian J, et al. survival in patients with severe lymphopenia following treatment with radiation and chemotherapy for newly diagnosed solid tumors. J Natl Compr Canc Netw 2015; 13: 1225-1231.
 
eISSN:1732-2707
ISSN:1730-1270
Journals System - logo
Scroll to top