The importance of risk factors for the prediction of patients with invasive pulmonary aspergillosis

Summary Objective: Invasive pulmonary aspergillosis (IPA) is a major challenge in the management of immunocompromised patients. Despite all the advances in diagnosis, it remains a problem. The purpose of our study was to investigate the risk factors associated with IPA seen in patients with hematological malignancies. Method: A total of 152 febrile neutropenia (FEN) patients with hematological malignancies aged over 18 years and receiving high-dose chemotherapy or stem cell transplant between January 1, 2010, and December 31, 2012 were included in the study. Sixty-five (65) cases with IPA according to the European Organization for the Research and Treatment of Cancer and Infectious Diseases Mycoses Study Group criteria were enrolled as the case group, while 87 patients without IPA development during concomitant monitoring were enrolled as the control group. Incidence of IPA was 21.4% (3/14) in patients receiving bone marrow transplant (allogeneic 2, autologous 1) and those cases were also added into the case group. The two groups were compared in terms of demographic, clinical and laboratory findings and risk factors associated with IPA investigated retrospectively. Results: Presence of relapse of primary disease, neutropenia for more than 3 weeks, presence of bacterial infection, and non-administration of antifungal prophylaxis were identified as risk factors associated with IPA. Conclusion: It may be possible to reduce the incidence of the disease by eliminating preventable risk factors. Predicting those risks would, per se, enable early diagnosis and treatment and, thus, the mortality rate of these patients would unquestionably decline.

Diagnostic importance of serological methods and eosinophilia in tissue parasites.

This case-control study was carried out to investigate whether eosinophilia is a common finding in parasitic diseases and to determine the prevalence of the parasitic diseases in definitive groups. Toxocariasis and fasciolosis were investigated in patients with eosinophilia, patients with non-eosinophilia, and healthy controls. All cases were analyzed for antibodies against Toxocara canis and Fasciola hepatica by modified enzyme-linked immunosorbent assay (ELISA) employing, as antigen, excretory/secretory products of Toxocara and Fasciola (ES-ELISA). Seropositivity was determined in 39 (29.1%) and 12 (8.9%) toxocariasis and fasciolosis patients with eosinophilia respectively. The seropositivity was found in 26 (19.4%) and 5 (3.7%) toxocariasis and fasciolosis patients without eosinophilia respectively. The seropositivity was found in 13 (15.5%) and 1 (1.2%) toxocariasis and fasciolosis patients in the control group. The total seropositivity in both toxocariasis and fasciolosis in the eosinophilic group (8.5%) increased significantly compared to patients without eosinophilia (23.1%) and healthy controls (6.6%) (chi2:6.343, p < 0.05 and chi2:10.293, p < 0.01). Eosinophilia correlated with antibodies against Toxocara and E. hepatica. The results suggest that serological methods can be used for diagnosis of parasitic infections in tissue. Thus, the actual prevalence of tissue parasites can be revealed particularly in developing and emerging countries.