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CORRESPONDENCE
Year : 2018  |  Volume : 66  |  Issue : 5  |  Page : 1525

Pituitary aspergillosis: A report and review of the literature


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication17-Sep-2018

Correspondence Address:
Dr. Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P.O. Box. 55302, Baghdad, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.241368

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How to cite this article:
Al-Mendalawi MD. Pituitary aspergillosis: A report and review of the literature. Neurol India 2018;66:1525

How to cite this URL:
Al-Mendalawi MD. Pituitary aspergillosis: A report and review of the literature. Neurol India [serial online] 2018 [cited 2018 Oct 23];66:1525. Available from: http://www.neurologyindia.com/text.asp?2018/66/5/1525/241368




Sir,

I refer to the interesting case report published by Divyashree et al. on pituitary aspergillosis (PA) in an Indian patient.[1] I assume that the development of PA in the studied patient could not be solely attributed to the underlying diabetes-associated jeopardized immunity. Among the important immunocompromised states that needed to be considered, infection with human immunodeficiency virus (HIV) was of utmost importance. My assumption is based on the following point. It is obvious that due to jeopardized immunity, HIV- infected individuals are more vulnerable to a wide range of bacterial, fungal, and parasitic infections compared to the immunocompetent individuals. Among fungal infections, aspergillosis has been reported in HIV-positive patients.[2] Studying central nervous system fungal infections in India has shown that 34% of infections were due to cryptococcosis and 16% of cases were due to aspergillosis.[3] Interestingly, 28% of cases were having an immunocompetent and 72% were having an immunocompromised status.[3] To my knowledge, HIV infection is a distressing health problem in India. The published data pointed to a 0.26% HIV seroprevalence compared with a global average of 0.2%.[4] I assume that the rare occurrence of PA should immediately alert the authors to define the HIV status in the studied patient. Hence, an initiation of the diagnostic workup involving the blood CD4 lymphocyte count and viral overload estimation was solicited. If that workup would have revealed HIV seropositivity, the case in question would have pointed to the presence of of HIV- associated aspergillosis that has until now rarely been reported in the Indian literature.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Divyashree S, Karthik R, Prabhu K, Chacko G. Pituitary aspergillosis: A report and review of the literature. Neurol India 2018;66:1176-8.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Gedela K, Nelson M, Francis N, Mohabeer M, Jones R. Cutaneous aspergillosis associated with HIV infection. Int J STD AIDS 2012;23:679-80.  Back to cited text no. 2
    
3.
Sethi PK, Khanna L, Batra A, Anand I, Sethi NK, Torgovnick J, et al. Central nervous system fungal infections: Observations from a large tertiary hospital in northern India. Clin Neurol Neurosurg 2012;114:1232-7.  Back to cited text no. 3
    
4.
Paranjape RS, Challacombe SJ. HIV/AIDS in India: An overview of the Indian epidemic. Oral Dis 2016;22 Suppl 1:10-4.  Back to cited text no. 4
    
5.
Kaur R, Mehra B, Dhakad MS, Goyal R, Dewan R. Pulmonary aspergillosis as opportunistic mycoses in a cohort of human immunodeficiency virus-infected patients: Report from a tertiary care hospital in North India. Int J Health Sci (Qassim) 2017;11:45-50.  Back to cited text no. 5
    




 

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