Bocci Maria Grazia, Cascarano Laura, Capecchi Giulia, Lesci Antonio, Sabatini Valerio, Rubino Dorotea, Stazi Giulia Valeria, Garotto Gabriele, Carrara Stefania, Vulcano Antonella, Gori Chiara, Del Nonno Franca, Colombo Daniele, Falasca Laura, Caraffa Emanuela, Cicalini Stefania, Fontana Carla
Clinical and Research Department, National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy.
Anesthesia and Intensive Care, San Camillo-Forlanini Hospital, 00152 Rome, Italy.
J Fungi (Basel). 2025 Aug 24;11(9):617. doi: 10.3390/jof11090617.
Aspergillosis in immunocompromised individuals is a serious and potentially life-threatening infection, as the weakened immune system cannot effectively fight the fungus. This review provides an in-depth examination of aspergillosis in patients with various conditions that compromise immunity, including hematological disorders, HIV, SARS-CoV-2 pneumonia, influenza, and those who have undergone solid organ transplants. The clinical manifestations of aspergillosis are influenced by factors such as the host's underlying comorbidities, immune response, and immune suppression due to medications or treatments. The review delves into the epidemiology of aspergillosis, exploring various risk factors that predispose individuals to infection. It also discusses the wide range of clinical symptoms, highlighting the challenges in diagnosis and the importance of early detection. The review contrasts traditional diagnostic approaches with emerging molecular techniques, emphasizing the role of advanced diagnostics in improving outcomes. A proposed clinical decision-making flowchart is provided to assist healthcare professionals in managing suspected cases of aspergillosis. In addition to diagnostic challenges, the review addresses antifungal prophylaxis, pre-emptive therapy, and the growing concern of pharmacological resistance to antifungal agents. It concludes with a discussion of future research directions, underscoring the need for improved therapeutic strategies and preventative measures in immunocompromised patients to reduce the burden of this severe fungal infection.
免疫功能低下个体的曲霉病是一种严重且可能危及生命的感染，因为免疫系统减弱无法有效对抗真菌。本综述深入探讨了在各种导致免疫功能受损的情况下患者的曲霉病，包括血液系统疾病、人类免疫缺陷病毒（HIV）、新型冠状病毒肺炎（SARS-CoV-2）、流感以及接受实体器官移植的患者。曲霉病的临床表现受宿主潜在合并症、免疫反应以及药物或治疗导致的免疫抑制等因素影响。该综述深入研究了曲霉病的流行病学，探索了使个体易感染的各种危险因素。它还讨论了广泛的临床症状，强调了诊断中的挑战以及早期检测的重要性。该综述将传统诊断方法与新兴分子技术进行了对比，强调了先进诊断在改善治疗结果中的作用。提供了一个拟议的临床决策流程图，以协助医疗保健专业人员管理疑似曲霉病病例。除了诊断挑战外，该综述还讨论了抗真菌预防、抢先治疗以及对抗真菌药物耐药性日益增加的关注。最后讨论了未来的研究方向，强调需要改进免疫功能低下患者的治疗策略和预防措施，以减轻这种严重真菌感染的负担。
