ABSTRACT
Fungal pathogens have begun to rival their bacterial counterparts as a significant problem in many settings. Death from fungal infection and bacterial infection are now almost equal in number in neutropenic patients. Besides the rise in occurrence of nosocomial yeast infections, infections with mold pathogens have emerged as an increasing risk faced by patients under sustained immunosuppression. Species of the Aspergillus family account for most of these infections and in particular Aspergillus fumigatus can be regarded as the primary mold pathogen. The improvement in transplant medicine and the therapy of hematological malignancies is often complicated by the threat of invasive aspergillosis. Specific diagnostics are still limited as are the possibilities of therapeutic intervention, leading to the disappointing fact that invasive aspergillosis is still associated with a high mortality rate that ranges from 30-90%. For example, during the past 15 years, invasive aspergillosis has become the main cause of death in patients with acute leukemia and liver transplantation [1, reviewed in 2]. However, the spectrum of diseases related to A. fumigatus is rather heterogeneous and exceeds that of a mere opportunistic pathogen: Colonization with restricted invasiveness is seen in the immunocompetent host, disseminated infections in the immunocompromised patients, and allergic disorders are known for long to be caused by A. fumigatus antigens [see articles in 3].
