Abstract

With various factors causing immunosuppression among humans and tendency towards opportunistic fungal infections such as aspergillosis, this study was therefore set up to assess the associated changing clinical presentations of the disease from the developing world. The study was based on literature search from available reports on clinical presentations of aspergillosis from literature searches for a period of 20 years (1990 - 2010). The most common forms of presentations of aspergillosis documented from the 9,743 patients in 1,222 literature reviews were invasive Pulmonary aspergillosis34.53% (3,365), allergic bronchopulmonary aspergillosis 18.13% (1,767), Pulmonary aspergillomas 15.41% (1,501) and aspergillosis of maxillary sinuses 8.05% (784). Some of the rarest presentations were aspergillus aortic embolism with stroke 0.04%, tension pneumothorax 0.07%, mycotic aneurism of descending thoracic aorta 0.06%, skull base erosion by sphenoid fungal balls 0.02%, small bowel obstruction 0.16%, perforation of large intestine 0.04%, small bowel infarction 0.03%, hypertrophic cranial pachmeningitis 0.34% and invasive generalised multi-organ aspergillosis 0.44%. Aspergillosis was found to present with various unusual surgical or medical emergencies with overall infection rates significantly higher in immunocompromised (P < 0.0001). In patients presenting with quite familiar clinical pictures in the developing world but proving difficult for treatment especially in the immunosuppressed but not exclusive and where facilities for diagnosis may be lacking, aspergillosis should not be completely ruled out.

Key words: Aspergillosis, clinical presentations, rare.