Aspergillosis: Case Series from the Central Public Health Laboratory–Ministry of Health. Asunción, Paraguay. Period 2000–2019

Abstract

Introduction: Aspergillosis is an opportunistic mycosis with significant impact on immunocompromised patients; available data in Paraguay are scarce. Objectives: To characterize patients diagnosed with aspergillosis whose samples were sent to the Mycology section of the Central Public Health Laboratory during the period 2000–2019. Methods: A descriptive, retrospective study of clinical records from patients with positive specimens for Aspergillus genus. Results: The study found 54 patients diagnosed with aspergillosis: 21 with otomycosis (38.9%), 17 with chronic pulmonary aspergillosis (31.5%), 5 with acute and chronic sinusitis (9.2%), 4 with invasive aspergillosis (7.4%), 3 with onychomycosis (5.6%), 2 with allergic bronchopulmonary aspergillosis (3.7%), and 2 with keratitis (3.7%). There were 56 isolates: 26 Aspergillus section fumigati (46.4%), 15 A. section flavi (26.8%), 13 A. section nigri (23.2%), 1 A. section terrei (1.8%), and 1 A. glaucus (1.8%). Microbiological diagnostic methods included fresh examination, staining, culture, and serology testing. Conclusions: Multiple cases of aspergillosis were reported over a 20-year period. Otomycosis, predominantly in adults, was the most prevalent form of aspergillosis. In chronic rhinopulmonary forms, tuberculosis, tumors, chronic obstructive disease, cystic fibrosis, and asthma were the predisposing factors. Invasive aspergillosis was predominantly observed in pediatric patients, with autoimmune diseases and leukemias being the primary risk factors. Aspergillus section fumigati was the predominant isolate, followed by Aspergillus section flavi and Aspergillus section nigri.

Keywords

• aspergillosis
• chronic obstructive pulmonary disease
• paraguay
• tuberculosis