[Epidemiology of and risk factors for invasive aspergillosis in nonneutropenic patients].

INTRODUCTION: Invasive aspergillosis is a major cause of mortality among patients with hematological malignancies and undergoing bone marrow transplantation. Whereas diagnosis and therapeutic strategies are evaluated for neutropenic patients, only limited data among nonneutropenic patients are available. STATE OF THE ART: Beside classical chronic pulmonary aspergillosis, an increased incidence of acute invasive aspergillosis is reported for nonneutropenic patients, such as patients suffering from chronic respiratory diseases or systemic diseases treated with corticosteroid therapy, and solid organ transplant recipients. PERSPECTIVES: A better knowledge of pathophysiology and epidemiology of invasive aspergillosis is needed to adapt the disease classification for nonneutropenic patients. Beside, the performance of diagnostic tools must be evaluated specifically in this population.
CONCLUSIONS: Invasive aspergillosis is underdiagnosed in nonneutropenic patients which may simultaneously be colonized by Aspergillus and receive immunosuppressive therapy. It remains a life-threatening disease as severe as in neutropenic patients, at least partially related to a delayed diagnostic.