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Ghanaat F, Tayek JA. Weight loss and diabetes are new risk factors for the development of invasive aspergillosis infection in non-immunocompromized humans. Clin Pract (Lond). 2017;14(5):296-301doi: 10.4172/clinical-practice.1000125.
Ghanaat, F., & Tayek, J. A. (2017). Weight loss and diabetes are new risk factors for the development of invasive aspergillosis infection in non-immunocompromized humans. Clinical practice (London, England), 14(5), 296-301. https://doi.org/10.4172/clinical-practice.1000125
Ghanaat, Farhad, and Tayek, John A. "Weight loss and diabetes are new risk factors for the development of invasive aspergillosis infection in non-immunocompromized humans." Clinical practice (London, England) vol. 14,5 (2017): 296-301. doi: https://doi.org/10.4172/clinical-practice.1000125
Ghanaat F, Tayek JA. Weight loss and diabetes are new risk factors for the development of invasive aspergillosis infection in non-immunocompromized humans. Clin Pract (Lond). 2017;14(5):296-301. doi: 10.4172/clinical-practice.1000125. PMID: 29670744; PMCID: PMC5901980.
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Clin Pract (Lond). 2017;14(5):296-301. doi: 10.4172/clinical-practice.1000125.

Weight loss and diabetes are new risk factors for the development of invasive aspergillosis infection in non-immunocompromized humans.

Clinical practice (London, England)

Farhad Ghanaat, John A Tayek

Affiliations

  1. Department of Internal Medicine, Los Angeles BioMedical Research Institute (LaBioMed), Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, USA.

PMID: 29670744 PMCID: PMC5901980 DOI: 10.4172/clinical-practice.1000125

Abstract

Well-established risk factors for aspergillosis include HIV, cancer, recent corticosteroid (prednisone) therapy, chemotherapy, or thoracic surgery. Non-established risk factors may include weight loss and a history of diabetes. Twenty-three patients without the classical risk factors for IA were identified retrospectively at Harbor UCLA Medical Center by discharge diagnosis over a 20 year period (1992-2012). None of the well-known risk factors are for Invasive Apergillious (IA). A history of weight loss was seen in 66% of the patients with IA (15 of 23). The weight loss ranged from 3.3 lbs to 43 lbs. In patients with weight loss the average loss was 22±3 lbs (mean±SEM). In this small group of patients with IA, diabetes was seen in 8 of the 23 (34%), which is significantly higher than the 19% incidence of diabetes seen in 100 patients with severe sepsis (p<0.05). Likewise, the 34% incidence of diabetes was higher than the 21% incidence reported in immunocompromised patients with invasive aspergillus (IA) infection (p<0.05). A reduced serum albumin concentration was seen in 33% of the study patients, which was less common than the 87% incidence seen in patients with severe sepsis or candidaemia (54%). Seventeen of the 23 patients had pulmonary involvement. While no one had a well-established risk factor for aspergillious, four patients had alcoholism as a potential risk factor. Eleven of the 23 (48%) died during the hospital stay despite antifungal therapy. Immunocompromised patients are known to have a mortality rate of approximately 45% for pulmonary or disseminated disease.

CONCLUSION: The incidence of diabetes was greater than seen in immunocompromised patients and may be considered an additional risk factor for the development of aspergillois infection. In addition, a history of weight loss should increase the suspicion for the diagnosis of IA in otherwise a non-immunocompromised patient. Early recognition and treatment of aspergillosis in the non-immunocompromised patient may improve outcome. Weight loss and diabetes should be added to the list of well-known risk factors for invasive aspergillosis and its high mortality rate.

Keywords: albumin; cachexia; diabetes; malnutrition; weight loss

Conflict of interest statement

Conflicts of interest: The authors declare no conflicts of interest.

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