Aspergillosis.

The microbiology, epidemiology, clinical features, and treatment of aspergillosis are discussed. Aspergillosis is a fungal infection that is increasingly found in patients with advanced HIV disease. The lung is involved in almost 75 percent of aspergillus infections. The central nervous system is the second most commonly infected site, occurring in about 10 to 15 percent of reported cases. Sinus involvement is recognized as a feature of aspergillosis, accounting for about 75 percent of all cases of fungal sinusitis seen in AIDS patients. While these infections are more than likely localized, dissemination to many organs can occur. The prognosis of patients with aspergillosis is poor, and its treatment is difficult. Treatment with amphotericin B is considered the gold standard, but responses are limited, with only 20 to 30 percent of patients responding in most cases. Itraconzole is approved as a second-line therapy. Surgery may also be appropriate for some cases of aspergillosis.