Question
Which of the following risk factors is most likely to be associated with invasive pulmonary aspergillosis?
| A. |
CD4 < 50 |
| B. |
Febrile neutropenia |
| C. |
Patient on steroids |
| D. |
Diabetes mellitus |
|
Correct Answer � B Explanation |
 |
– Invasive pulmonary aspergillosis predominantly occurs in patients with prolonged and severe neutropenia, such as those undergoing chemotherapy for hematologic malignancies.
– Neutrophils play a critical role in controlling Aspergillus infections; neutropenia impairs the ability to clear fungal spores leading to invasive disease.
– Febrile neutropenia reflects a state of compromised innate immunity, making patients highly susceptible to invasive fungal infections like aspergillosis.
Reasons to rule out other options:
– A. CD4 < 50: This is a risk factor for Pneumocystis jirovecii pneumonia, not invasive aspergillosis.
– C. Patient on steroids: While corticosteroids increase the risk due to immunosuppression, the risk is greatest when combined with neutropenia. Steroids alone are less strongly associated.
– D. Diabetes mellitus: More commonly associated with mucormycosis rather than invasive aspergillosis.