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Inicio Medicina Clínica (English Edition) Invasive aspergillosis: A comprehensive review
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Vol. 163. Issue 4.
Pages 189-198 (August 2024)
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Vol. 163. Issue 4.
Pages 189-198 (August 2024)
Review
Invasive aspergillosis: A comprehensive review
Aspergilosis invasiva: una revisión exhaustiva
Marina Machadoa,b,d,
Corresponding author
marina.machado@salud.madrid.org

Corresponding author.
, Jesús Fortúnc,d,e,f, Patricia Muñoza,b,g,h
a Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
c Infectious Diseases Department, Hospital Ramón y Cajal, Madrid, Spain
d Universidad de Alcalá, Escuela de Doctorado, Alcalá de Henares, Spain
e IRYCIS: Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
f CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
g CIBER de Enfermedades Respiratorias – CIBERES (CB06/06/0058), Madrid, Spain
h Medicine Department, Faculty of Medicine, Universidad Complutense de Madrid, Spain
Article information
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Figures (2)
Tables (3)
Table 1. European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) 2019 updated criteria.33
Table 2. Dosage for antifungals in invasive aspergillosis.
Table 3. New antifungals for invasive aspergillosis therapy.
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Abstract

Invasive aspergillosis (IA) is a severe fungal infection caused by Aspergillus species, particularly Aspergillus fumigatus, although new species, sometimes resistant to antifungals are becoming more common. IA predominantly affects immunocompromised patients, such as those with haematological malignancies, solid organ transplant recipients, and critically ill patients. However, new at-risk populations have emerged in recent years, such as IA associated with severe viral infections. Advanced diagnostic methods are crucial, especially considering the rising concern of antifungal resistance. Early detection is critical for successful treatment, typically involving antifungal medications like voriconazole or amphotericin B, but new antifungals are arriving to complete the therapeutic strategies. Despite advancements, mortality rates remain high, underscoring the importance of timely interventions and ongoing research. Healthcare providers should maintain a high index of suspicion, especially in immunocompromised patients and other new risk factors that are arising, to promptly diagnose and manage invasive aspergillosis.

Keywords:
Invasive aspergillosis
Aspergillus fumigatus
Pulmonary aspergillosis
Invasive fungal infections
Resumen

La aspergilosis invasiva (AI) es una infección fúngica grave causada por Aspergillus spp., en particular Aspergillus fumigatus. Cada vez es más frecuente identificar otras especies, en ocasiones resistentes a los antifúngicos. La AI afecta predominantemente a pacientes inmunodeprimidos, como los pacientes con neoplasias hematológicas, receptores de trasplante de órgano sólido y los pacientes críticos. Sin embargo, en los últimos años han surgido nuevas poblaciones de riesgo, como la AI asociada a infecciones víricas graves. Los métodos de diagnóstico avanzados son cruciales, especialmente si se tiene en cuenta la creciente preocupación por la resistencia a los antifúngicos. El tratamiento suele incluir antifúngicos como el voriconazol o la anfotericina B liposomal, con nuevos antifúngicos en desarrollo que completarán las estrategias terapéuticas. A pesar de los avances, las tasas de mortalidad siguen siendo elevadas. Los profesionales sanitarios deben mantener un alto índice de sospecha, especialmente en pacientes inmunodeprimidos e identificar adecuadamente otras nuevas poblaciones en riesgo.

Palabras clave:
Aspergilosis invasiva
Aspergillus fumigatus
Aspergilosis pulmonar
Infección fúngica invasiva

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