New medical technologies have been developing very quickly in the last decades. A significant success was achieved in treatment of oncological and oncohematological diseases. Development of transplantology increases chances of oncologic patients for recovery. However application of cytostatic and immune suppressing medications, ensuring functioning of transplantates, leads to severe decreasing of immunity and appearance of complications in a form of opportunistic infections. Besides, group of infections development risk includes patients suffering from acquired immune deficiency syndrome (AIDS), complications after abdominal surgical interventions, major severe burns, and premature newborns or newborns subjected to aggressive medical therapy within the first days of life (parenteral feeding and massive antibacterial therapy). Among contributive risk factors of invasive mycoses development are intake of antibiotic with a wide spectrum for more than two weeks, total intravenous nutrition, continuous artificial lung ventilation, shock, preceding mycotic infections.
Results of 8124 autopsies show that incidence of mycotic infections in clinics of Frankfurt on the Main has increased from 2.2% in 1978 to 5.3% in 2004. This increase happened mainly due to aspergillus infection, incidence of which has increased 10 times within this period of time.
A peculiarity of aspergillus infection course is a variety of its clinical manifestations. Therapists single out invasive and non-invasive aspergillosis.
Invasive pulmonary aspergilliosis (IPA) is the most severe form of the disease, when dissemination of the process into other organs (CNS, parenchymatous organs of abdominal cavity) is possible. Often the first symptom of invasive mycotic infection is a fever, refractory to broad-spectrum antibiotics. Absence of a result at treatment with antibacterial preparations at clinical picture of acute pneumonia in patients with expressed immune suppression must be regarded as a possibility of IPA development. When such clinical manifestations are registered diagnostic maneuvers must be fulfilled. Speed and intensity of IPA manifestations depend on degree of immune suppression. IPA signs reveal themselves distinctly after granulocytopaenia, Sometimes IPA diagnosis may be made basing on results of a biopsy only, but a risk of haemorrhagic complications in patients with hemoblastoses may be one of barriers for biopsy.
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