Factors affecting patient outcome in primary cutaneous aspergillosis

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dc.citation.articleNumbere3747
dc.citation.issueNumber26
dc.citation.journalTitleMedicine
dc.citation.volumeNumber95
dc.contributor.authorTatara, Alexander M.
dc.contributor.authorMikos, Antonios G.
dc.contributor.authorKontoyiannis, Dimitrios P.
dc.date.accessioned2016-09-30T20:52:22Z
dc.date.available2016-09-30T20:52:22Z
dc.date.issued2016
dc.description.abstractPrimary cutaneous aspergillosis (PCA) is an uncommon infection of the skin. There is a paucity of organized literature regarding this entity in regard to patient characteristics, associated Aspergillus species, and treatment modalities on outcome (disease recurrence, disease dissemination, and mortality). We reviewed all published reports of PCA from 1967 to 2015. Cases were deemed eligible if they included the following: patient baseline characteristics (age, sex, underlying condition), evidence of proven or probable PCA, primary treatment strategy, and outcome. We identified 130 eligible cases reported from 1967 to 2015. The patients were predominantly male (63.8%) with a mean age of 30.4 ± 22.1 years. Rates of PCA recurrence, dissemination, and mortality were 10.8%, 18.5%, and 31.5%, respectively. In half of the cases, there was an association with a foreign body. Seven different Aspergillus species were reported to cause PCA. Systemic antifungal therapy without surgery was the most common form of therapy (60% of cases). Disease dissemination was more common in patients with underlying systemic conditions and occurred on average 41.4 days after PCA diagnosis (range of 3–120 days). In a multivariate linear regression model of mortality including only patients with immunosuppressive conditions, dissemination and human immunodeficiency virus/acquired immune deficiency syndrome were statistically significantly associated with increased mortality. Nearly one-third of patients with PCA die with the disease. Dissemination and host status are critical in patient outcome.
dc.identifier.citationTatara, Alexander M., Mikos, Antonios G. and Kontoyiannis, Dimitrios P.. "Factors affecting patient outcome in primary cutaneous aspergillosis." <i>Medicine,</i> 95, no. 26 (2016) Wolters Kluwer: http://dx.doi.org/10.1097/MD.0000000000003747.
dc.identifier.doihttp://dx.doi.org/10.1097/MD.0000000000003747
dc.identifier.urihttps://hdl.handle.net/1911/91636
dc.language.isoeng
dc.publisherWolters Kluwer
dc.rightsThis is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subject.keywordaspergillosis
dc.subject.keywordcutaneous
dc.subject.keywordfungal infection
dc.subject.keywordinfectious diseases
dc.titleFactors affecting patient outcome in primary cutaneous aspergillosis
dc.typeJournal article
dc.type.dcmiText
dc.type.publicationpublisher version
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