Description of invasive aspergillosis in Mexican patients with chronic granulomatous disease

In chronic granulomatous disease (CGD), Aspergillus is the most common cause of invasive fungal infections and accounts for a high percentage of mortality. We recruited 45 patients of CGD with invasive aspergillosis (IA) events. The median age between the first CGD manifestation and first aspergillosis event was 65 mo. Mortality rate was 57.7% for proven aspergillosis events, 23.1% for probable events, and 19.2% for possible events (p = 0.038). Aspergillus fumigatus was the most common species. Comparing mortality with this cutoff point, 36% of those receiving <75 days of antifungal treatment died compared with 16.7% of those receiving >75 days (p = 0.05). 26 (58%) of the 45 patients died, out of which 18 (69%) had IA. Overall survival of the 45 patients was 80.8% at 64 mo. The high mortality rate of IA in CGD patients could be reduced by early suspicion, initiating correct antifungal treatment over a long period, and considering the performance of hematopoietic stem cell transplantation.