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Title: An investigation of the problem of invasive aspergillosis in neutropenic patients
Author: Barnes, R. A.
Awarding Body: University of London
Current Institution: Imperial College London
Date of Award: 1988
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Invasive pulmonary aspergillosis (IPA) is one of the most rapidly increasing mycoses affecting immunocompromised patients. Patients with haematological malignancies and transplant recipients are particularly at risk. Aspergillosis is a major cause of death in these groups. The paucity of clinical features and the difficulties in establishing the diagnosis often lead to a delay in the initiation of antifungal treatment and hence contribute to the high mortality seen in this condition. During an in depth study of 89 bone marrow transplant and acute leukaemic patients including 18 with IPA, the clinical features of, and risk factors for aspergillosis have been analysed. Furthermore, an immunodiagnostic assay for antigen detection has been evaluated and found to be the most sensitive and specific method for diagnosis of IPA. This increased awareness of the problem combined with improved diagnostic methods has allowed the earlier initiation of specific antifungal treatment and contributed towards improved survival. The results of an epidemiological survey have shown that inhalation of airborne spores represents the most important extrinsic risk factor for acquisition of nosocomial aspergillosis. Air filtration systems that remove fungal spores from patient care areas reduce the incidence of aspergillosis and their use is recommended in all high-risk units.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available